Exocrine pancreatic insufficiency in tropical sprue

Background: Pancreatic insufficiency may appear secondary to several intest inal disorders. It may contribute to malabsorption in tropical sprue (TS). Methods: The exocrine pancreatic function was evaluated with the indirect p ancreolauryl test (PT) in 56 patients with TS. The PT results were analyzed and correlated with serum albumin levels, degree of intestinal atrophy, an d steatorrhea. Results:Abnormally low values were found in 36 (64.2%) cases. A significant relationship was not observed between PT and hypoalbuminemia. Patients wit h more severe damage by intestinal biopsy tended to have lower PT values. N o relationship was found between pancreatic insufficiency and steatorrhea ( expressed as g/24 h), but patients with pancreatic insufficiency had increa sed stool fat concentrations (expressed as percentage of wet stool weight). All patients responded favorably to treatment with folic acid and tetracyc line. Fifteen patients with abnormal initial PT values underwent a repeat P i after a 6-week therapy; all of them showed normalization of PT values. Conclusions: The abnormal exocrine pancreatic function found with an indire ct test in patients with TS is probably secondary to a low pancreatic hormo nal stimulation due to intestinal damage, as occurs in celiac sprue. These abnormalities are reversible after specific treatment for TS. Copyright (C) 2001 S. Karger AG, Basel.