Abstract
PANCREATIC LIPOMATOSIS IN TWO SIBLINGS PRESENTING WITH STEATORRHEA: A CASE REPORT
Michelle Dawn Y. Ramos, MD
Chong Hua Hospital Fuente Osmeña St., Cebu City
Significance: Pancreatic lipomatosis is a rare disease with an unknown etiology characterized by the replacement of pancreatic acinar cells with adipose tissue associated with preservation of pancreatic duct and islet cell histology.
Clinical Presentation: In this paper, we report the case of two 40- and 46-year-old siblings who both presented with a 10-year history of recurrent steatorrhea aggravated by eating fatty food. The older sibling was diagnosed with papillary thyroid carcinoma and underwent total thyroidectomy. Post-operative monitoring showed recurrent hypocalcemia despite prolonged calcium supplementation warranting further workup for malabsorption. Abdominal CT scan done revealed total fatty replacement of the pancreas with some remnant pancreatic parenchyma. The younger sibling, who had no other associated symptoms nor comorbidities, also underwent a CT scan with the same results. Both patients had low serum lipase levels with normal glycated hemoglobin and serum glucose levels indicating evidence of pancreatic exocrine insufficiency with preserved endocrine function. Low fat diet and pancreatic enzyme supplements were started with improvement of steatorrhea. Pancreatic lipomatosis (PL) may often be overlooked as a possible cause of malabsorption due to its rarity. However, establishing its diagnosis may easily be done through documentation of typical imaging findings and treatment initiated with dietary modification and pancreatic enzyme supplementation. Isolated cases of PL have been identified with no published reports involving its occurrence in siblings and a familial nature, as documented in this report. Further genetic testing is recommended to establish this association which may aid in future studies involving the prevention and treatment of the disease.
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |