Acute pancreatitis in marrow transplant patients: prevalence at autopsy and risk factor analysis
Autor: | H. G. Schoch, David Myerson, George E. Sale, George B. McDonald, Howard M. Shulman, Robert C. Hackman, CW Ko, SP Lee, Ted Gooley |
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Rok vydání: | 1998 |
Předmět: |
Adult
Male medicine.medical_specialty Pancreatic disease Transplantation Conditioning Graft vs Host Disease Autopsy Gastroenterology Cohort Studies Risk Factors Internal medicine Cause of Death Neoplasms medicine Prevalence Bile Humans Biliary sludge Risk factor Bone Marrow Transplantation Transplantation business.industry Gallbladder Hematology medicine.disease Surgery Abdominal Pain surgical procedures operative Graft-versus-host disease Methotrexate Pancreatitis Acute Disease Amylases Cyclosporine Acute pancreatitis Prednisone Drug Therapy Combination Female business Biomarkers Immunosuppressive Agents Whole-Body Irradiation |
Zdroj: | Bone marrow transplantation. 20(12) |
ISSN: | 0268-3369 |
Popis: | Pancreatitis has been described as an infrequent complication of marrow transplantation. This study investigated the prevalence of pancreatitis at autopsy in marrow transplant patients and determined risk factors for its development. We reviewed consecutive autopsy reports from 1991 to 1993. Medical records and laboratory reports were reviewed for analysis of clinical variables. Autopsy findings and clinical variables were correlated with the autopsy diagnosis of pancreatitis. Pancreatitis was found in 51 of 184 (28%) patients at autopsy. Of those with pancreatitis, 35% had abdominal pain, 10% had measurements of serum pancreatic enzymes, and 20% had abdominal imaging studies in the week prior to death. By univariable analysis, risk factors associated with development of pancreatitis included clinical grades 3 and 4 GVHD, GVHD at autopsy, liver GVHD at autopsy, major infection at autopsy, and increasing days of survival. By multivariable analysis, independent risk factors for its development included any GVHD at autopsy, increasing length of survival after transplantation, and major infection at autopsy. We conclude that pancreatitis is a common but often subclinical complication of marrow transplantation. Its development may be associated with a high prevalence of biliary sludge and prolonged treatment of GVHD with cyclosporine and prednisone. |
Databáze: | OpenAIRE |
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