Chronic Asymptomatic Pancreatic Hyperenzymemia: A Long-term Follow-up

Pancreas. 2019 Apr;48(4):544-547. doi: 10.1097/MPA.0000000000001272.

Abstract

Objectives: Chronic asymptomatic pancreatic hyperenzymemia (CAPH) was described as a benign disease. However, we already described clinically relevant findings requiring surgery or follow-up in half of the subjects. The aim of this study was to evaluate the long-term outcome of CAPH in terms of symptoms and evolution toward chronic pancreatitis.

Methods: Subjects previously enrolled in the first phase of the study (from 2005 to 2010) were reinvestigated from December 2013 to January 2017 with a phone call ± magnetic resonance cholangiopancreatography with secretin stimulation.

Results: A total of 133 subjects were eligible for the follow-up study (75 males, 58 females; age, 48.4 [standard deviation {SD}, 14] years); 24 (18%) of them dropped out. During a mean follow-up of 9.3 (SD, 5.2) years after the first diagnosis of CAPH, no episode of acute pancreatitis or abdominal pain was reported. Sixty-three subjects (58%) of 109 underwent magnetic resonance cholangiopancreatography with secretin stimulation with a mean follow-up of 5.7 [SD, 3.1] years (range, 1-11 years). Secretin stimulation-MRCP resulted unchanged in 54 (90%) of 60 subjects, worsened in 3 (5%) and improved in 3 (5%). Two subjects died from causes unrelated to pancreatic disease.

Conclusions: Excluding subjects with a pancreatic disease at index magnetic resonance imaging, CAPH is a benign condition.

MeSH terms

  • Adult
  • Amylases / blood*
  • Cholangiopancreatography, Magnetic Resonance / methods*
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Humans
  • Lipase / blood*
  • Male
  • Middle Aged
  • Pancreas / diagnostic imaging*
  • Pancreas / enzymology
  • Pancreas / pathology
  • Pancreatic Diseases / blood
  • Pancreatic Diseases / diagnostic imaging*
  • Pancreatic Diseases / enzymology
  • Pancreatitis, Chronic / blood
  • Pancreatitis, Chronic / diagnostic imaging*
  • Pancreatitis, Chronic / enzymology
  • Time Factors

Substances

  • Lipase
  • Amylases