PANCREATIC FUNCTION AND DISEASE IN EARLY LIFE. I. PANCREATIC ENZYME ACTIVITY AND THE CELIAC SYNDROME 1

Abstract

Over 150 detns. were reported of the pancreatic enzyme activity and of the volume and character of the fluid in the duodenal content of infants and children, some of whom were normal individuals and others patients suffering from chronic nutritional disturbance, idiopathic celiac disease and pancreatic fibrosis. It was found that pancreatic achylia was a constant and characteristic finding in patients with important obstructive changes in the duct-acinar system of the pancreas (pancreatic fibrosis) as proved postmortem. Patients with idiopathic celiac disease, non-tropical sprue or idiopathic steatorrhea showed no evidence of pancreatic achylia or hypochylia. One instance of selective trypsin deficiency in the presence of normal lipolytic and amylolytic activity was described. The demonstration of pancreatic achylia and pancreatic fibrosis in an infant with meconium ileus was reported. Data were given concerning pancreatic enzyme activity in infants with liver disease, asthma, eczema, pertussis, cretinism or nephrosis and also in 3 prematurely born infants. Detns. of pancreatic enzyme activity in infants suffering from hypogly-cemia and from whom 70-80% of the pancreas had been removed surgically showed an appreciable reduction in enzyme activity but no evidence of pancreatic insufficiency.