Pancreatic involvement in chronic viral hepatitis

Abstract

Aim: To elucidate the frequency and characteristics of pancreatic disorders in the course of chronic viral hepatitis.

Methods: We prospectively assessed the serum pancreatic enzyme levels and imaging findings in patients with chronic viral hepatitis and healthy control subjects.

Results: Serum amylase (t-Amy), salivary amylase (s-Amy), pancreatic amylase (p-Amy) and serum lipase levels were higher in hepatitis patients in comparison to control subjects. However, in asymptomatic viral carriers, only the serum t-Amy levels were higher than those of the controls. The levels of each enzyme rose with the progression of liver disease in patients with hepatitis B or C; whereas the levels of each enzyme within the same clinical stage of the disease did not differ between patients diagnosed with either hepatitis B or hepatitis C virus. Imaging findings demonstrated chronic pancreatitis in only 1 out of 202 patients (0.5%).

Conclusion: Our data suggest that serum levels of pancreatic enzymes increase with the progression of liver disease in patients diagnosed with viral hepatitis. Pancreatic disease, asymptomatic in most cases, may represent an extrahepatic manifestation of chronic viral hepatitis.

Figure 1

Levels of serum or tissue enzymes in patients with CLD compared to those measured in age and sex-matched control subjects. ^bP<0.01 vs controls.

Figure 2

Levels of serum or tissue enzymes at each clinical stage of CH B. ^aP<0.05 vs controls.

Figure 3

Levels of serum or tissue enzymes at several stages of CH C. ^aP<0.05 vs controls.

Figure 4

Distribution of serum enzyme levels at several stages of CH B. Box plots are given with horizontal lines for the medians, upper and lower edges indicating the 25^th and 75^th percentiles, respectively, and bars represent the extremes without including outliers. _ indicates outliers and ● indicates extremities. P values indicate the correlation between the enzyme levels and the progression of liver disease (A-D). ^aP<0.05, ^bP<0.01 vs others.

Figure 5

Distribution of serum enzyme levels in several stages of CH C. Box plots are given with horizontal lines for the medians, upper and lower edges indicating the 25^th and 75^th percentiles, respectively, and bars represent the extremes without including outliers. _ indicates outliers and ● indicates extremities. P values indicate the correlation between the enzyme levels and the progression of liver disease (A-D). ^aP<0.05, ^bP<0.01 vs others.

Figure 6

Comparison of serum and tissue enzyme levels between HBV and HCV carriers (A-C).