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Abstract
Severe pancreatic exocrine insufficiency was demonstrated in a 41 year old man with
familial type I hyperlipoproteinemia (fat-induced hyperlipemia). Plasma triglyceride
concentration failed to increase significantly with increased dietary fat intake,
and fecal fat excretion was markedly increased. Indices of intestinal function were
normal. Pancreatic enzyme therapy resulted in reduced fat excretion and increased
plasma triglyceride concentration. Secretin stimulation tests revealed impaired duodenal
fluid volume, bicarbonate and pancreatic enzyme responses. Insulin-dependent diabetes
mellitus had been diagnosed three years earlier. No attacks of acute pancreatitis
had occurred in the preceding 20 years, and it is suggested that pancreatic damage
may have resulted from repeated subclinical pancreatic insults due to elevated plasma
lipid levels. This report is the first to indicate that pancreatic exocrine insufficiency
may occur as a late complication of hyperlipemic disorders in the absence of recurrent
acute pancreatitis. Steatorrhea may not be apparent because of therapeutic restriction
of dietary fat, and the first manifestation of pancreatic exocrine disease may be
an amelioration of fat-induced hyperlipemia.
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Article info
Publication history
Accepted:
February 23,
1976
Identification
Copyright
© 1977 Published by Elsevier Inc.
