Abstract
During prolonged fasting, the absence of enteric stimulation might lead to pancreatic hypofunction or atrophy. The ahility of the pancreas to respond to exogenous secretagogues following fasting in conjunction with TPN in infancy is not known. In addition, while severe degrees of malnutrition (M) are known to adversely affect pancreatic structure and function (PF), it is unknown whether infants presenting with chronic diarrhea and first degree M could have alterations in PF. The results of panereozymin-secretin tests were analyzed in the following patient groups: 7 infants receiving TPN for >6 weeks for severe diarrhea in association with short bowel syndrome or intractable diarrhea; 17 infants exhibiting first degree M and chronic diarrhea and 12 controls (age matched well nourished infants with chronic diarrhea). No significant difference was found among the 3 groups in the volume of fluid collected following either cholecystokinin or secretin. The content and concentration of amylase and lipase were lower in those receiving TPN following secretin (p<0.05) .Peak specific activity and total trypsin and protein content were similar in all groups
The findings indicate that fasted infants receiving TPN retain their ability to respond to pancreatic secretagogues. However, the enzyme output is affected differently. Amylase and lipase exhibit an attenuated response whereas that of trypsin is maintained. No impairment in exocrine pancreatic secretion was found in infants suffering mild M.
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Rossi, T., Lee, PC. & Lehenthal, E. TOTAL PARENTKRAL NUTRITION (TPN) IN INFANCY AFFECTS AMYLASE AND LIPASE BUT NOT TRYPSIN SECRETION. Pediatr Res 21 (Suppl 4), 276 (1987). https://doi.org/10.1203/00006450-198704010-00656
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DOI: https://doi.org/10.1203/00006450-198704010-00656