Q) All are true about tropical pancreatitis except?
a. Associated with Tapioca.
b. Patients have large stones with fibrosis.
c. It is Pre Cancerous
d) Onset of disease at 50 years
Free.
Answer -d )Onset of disease is at young age
Tropical pancreatitisis an idiopathic disease which begins in teens. It has a high association with diabetes and Pancreatic duct calculi. It is common in South India, Asia, Africa and central America.
Etiology of tropical pancreatitis includes
Malnutrition
Cassava
Hydrocarbons exposure
It is associated with SPINK 1 mutation
It is pre cancerous
IPSG data shows the cumulative risk of Pancreatic Cancer in patients with Chronic Pancreatitis (predominantly of alcoholic aetiology) was reported as 1.8 % and 4 % at 10 and 20 years respectively. This risk was reported to be independent of age, sex and type of pancreatitis.
The link between CP and PC is clearer in certain subtypes of CP like tropical pancreatitis and hereditary pancreatitis.
Augustine et al. reported a 8.3 % incidence of pancreatic cancer in patients with tropical pancreatitis, which is much higher than western figures.
Ref
Pancreatic Cancer in Chronic Pancreatitis
Clinical Picture of tropical pancreatitis
a child, adolescent or young adult , recurrent upper abdominal pain, diabetes mellitus, malnutrition, nutrient deficiencies, nutritional edema, cyanotic hue of the lips, parotid enlargement and pancreatic calculi on plain abdominal X ray
Ref https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1742869/pdf/v079p00606.pdf