EXOCRINE PANCREATIC INSUFFICIENCY AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION

Several reports suggest a relationship between bone marrow transplanta tion and pancreatic damage. The authors describe two patients with pan creatic insufficiency after bone marrow transplantation. The first pat ient had weight loss arising from steatorrhea secondary to severe panc reatic insufficiency (lipase output result <3% of normal) due to pancr eatic atrophy. The second patient had steatorrhea secondary to intesti nal bacterial overgrowth, but moderate pancreatic insufficiency was pr esent (results of trypsin and lipase outputs were 50 and 30% of normal ). Before the diagnosis of pancreatic insufficiency, both patients had acute graft vs host disease and the second patient had chronic graft vs host disease. We conclude that graft vs host disease after bone mar row transplantation may damage the pancreas. Patients with persistent malabsorption after bone marrow transplantation should be tested for e xocrine pancreatic insufficiency.