GASTRO-INTESTINAL STUDIES. II. PANCREATIC ENZYMES IN PERNICIOUS ANEMIA

Abstract

The fasting gastric contents and the duodenal juice after acid stimulation was studied in 5 controls and in 22 patients with pernicious anemia. The amylase, lipase, trypsin and trypsinogen were determined. Though there was considerable variation, pancreatic enzymes were always present in the duodenal juice. Patients with pernicious anemia who had lowered amounts, especially of trypsin and trypsinogen, had moderate to advanced central nervous system involvement. The tryptic activity of the duodenal juice was considerably enhanced by activation with enterokinase. It was believed that the determination of the tryptic power after activation with enterokinase offered a more accurate index of pancreatic function, since at least two factors must be considered as playing a rale in determining the amount of tryptic activity in the duodenal juice[long dash]namely, the ability of the pancreas to secrete trypsinogen and the ability of the duodenal mucosa to secrete enterokinase to activate the trypsinogen. The fasting gastric contents were of no value in determining the external secretory activity of the pancreas.