Ultrasonography of the pancreas, as a function index, in children with beta-thalassemia

Increased echogenicity of the pancreas, due to hemosiderosis, is a frequent laboratory finding in children and adolescents with beta-thalassemia(1), T he aim of this study was to investigate whether increased echogenicity of t he pancreas is associated with dysfunction, The ultrasonic image of the pan creas was examined in 34 children aged 12+/-3.8 years old and was compared to the endocrine and exocrine functioning of the gland. Oral glucose tolera nce test (OGTT) was performed with simultaneous measurement of insulin and serum trypsin, Twenty-six of the 34 patients (76.5%) presented increased ec hogenicity, while 8 (23.5%) had a normal ultrasonic pancreatic image. 77% o f the patients with increased echogenicity had abnormal OGTT, 46% with subn ormal or increased insulin values, and 32.5% manifested low levels of tryps in, Among the patients with normal ultrasound, 25% had abnormal OGTT and 37 .5% abnormal insulin values. Statistical analysis with Student's t-test rev ealed that patients with increased echogenicity had significantly higher gl ucose values on OGTT at 60': 7.6+/-1.8 mmol/l (137.3+/-33.7 mg/dl) as compa red. to the patients with normal ultrasound: 6.1+/-1.2 mmol/l (110.75+/-21. 72 mg/dl) (p<0.05), Insulin values were significantly affected at 30, 60, a nd 90 min: 570+/-301, 332+/-156, 294+/-158 pmol/l (79.54+/-42, 46.4+/-21.8, 41.04+/-22 mU/l) respectively in patients with increased echogenicity in c omparison to those with normal ultrasonographic image of the gland: 301+/-1 70, 192+/-52, 135+/-63 pmol/l (42+/-23.7, 26.85+/-7.36, 18.9+/-8.8 mU/l) (p <0.05). No statistical significance was observed between the two groups reg arding trypsin levels, even though abnormal values were observed in more ch ildren with increased echogenicity than in patients with a normal ultrasoun d. The above findings confirm that increased echogenicity of the pancreas i s associated with disturbance of its function. This simple imaging method c ould be used as a rough early index of detection of an increased risk for d eveloping diabetes mellitus in patients with beta-thalassemia.