Idiopathic Relapsing Pancreatitis in a Young Woman: An Unexpected Solution
Objective: to present a complicated case history of idiopathic recurring pancreatitis in a 23-year old woman.
Key Points. The main clinical manifestation of the disease was acute intense recurring abdominal pain. Despite symptomatic treatment, the condition of the patient worsened, and the abdominal pain became more intensive. An adequate dose of an enzyme replacement therapy resulted in longer periods of remission. Differential diagnosis and additional laboratory and instrumental examinations helped in finding the root cause of pancreatitis and diagnosing cystic fibrosis with pancreas involvement. The hallmarks of this clinical case were diagnosis of cystic fibrosis (a genetic disorder) in an adult, absence of marked clinical symptoms of lungs involvement, and no signs of retarded physical and sexual development, as well as manifestations of malnutrition. Cystic fibrosis was confirmed by German specialists.
Conclusion. Currently the patient is undergoing treatment in a German clinic. Long-lasting enzyme replacement therapy was recommended; a decision to start gene therapy has not been taken yet. We are now considering the need in pancreatic duct in order to prevent recurrent pancreatic attacks.
Contribution: Gubergritz, N.B. — idea and clinical diagnostics; examination plan; Monogarova, N.E. — clinical interpretation of respiratory changes; Lukashevich, G.M. — written compilation of the clinical observation results; Belyaeva, N.V. — patient coordination; Fomenko, P.G. — article preparation, arrangement of references; Shpak, S.A. — radiology examination and interpretation; Bakhchevan, E.L. — genetic researches and interpretation; Burka, A.A. — cystic fibrosis diagnosis formulation.
Conflict of interes: The authors declare that they do not have any conflict of interests.
N.E. Monogarova — M. Gorky Donetsk National Medical University; 27 Privokzalnaya Str., Liman, Donetsk Region, Ukraine 84404. E-mail: email@example.com
G.M. Lukashevich — M. Gorky Donetsk National Medical University; 27 Privokzalnaya Str., Liman, Donetsk Region, Ukraine 84404. E-mail: firstname.lastname@example.org
N.V. Belyaeva — M. Gorky Donetsk National Medical University; 27 Privokzalnaya Str., Liman, Donetsk Region, Ukraine 84404. E-mail: email@example.com
P.G. Fomenko — M. Gorky Donetsk National Medical University; 27 Privokzalnaya Str., Liman, Donetsk Region, Ukraine 84404. E-mail: firstname.lastname@example.org
S.A. Shpak — Kiev Municipal Clinical Hospital No.7; 95 Mikhail Kotelnikov Str., Kiev, Ukraine 03179. E-mail: email@example.com
E.L. Bakhchevan — St. Paul’s German Diagnostic Centre; 68/2 Novoselskiy Str., Odessa, Ukraine 65023. E-mail: firstname.lastname@example.org
A.A. Burka — Municipal Children’s Hospital No. 38 of the Moscow Department of Health; 2 10-letiya Oktyabrya Str., Moscow, Russian Federation 117036. E-mail: email@example.com
- Carrier Testing for Cystic Fibrosis. Cystic Fibrosis Foundation. 2019. URL: https://www.cff.org/What-is-CF/Testing/Carrier-Testing-for-Cystic-Fibrosis (дата обращения — 15.09.2019).