Balaban DV, Enache I, Ciochina M, Popp A, Jinga M. Pancreatic involvement in celiac disease. World J Gastroenterol 2022; 28(24): 2680-2688 [PMID: 35979168 DOI: 10.3748/wjg.v28.i24.2680]
Corresponding Author of This Article
Daniel Vasile Balaban, MD, PhD, Senior Lecturer, Department of Internal Medicine and Gastroenterology, Carol Davila University of Medicine and Pharmacy, 134 Calea Plevnei, Bucharest 020021, Romania. vbalaban@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jun 28, 2022; 28(24): 2680-2688 Published online Jun 28, 2022. doi: 10.3748/wjg.v28.i24.2680
Pancreatic involvement in celiac disease
Daniel Vasile Balaban, Iulia Enache, Marina Ciochina, Alina Popp, Mariana Jinga
Daniel Vasile Balaban, Iulia Enache, Marina Ciochina, Mariana Jinga, Department of Internal Medicine and Gastroenterology, Carol Davila University of Medicine and Pharmacy, Bucharest 020021, Romania
Daniel Vasile Balaban, Iulia Enache, Marina Ciochina, Mariana Jinga, Dr. Carol Davila Central Military Emergency University Hospital, Bucharest 020021, Romania
Alina Popp, Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, Bucharest 020021, Romania
Alina Popp, National Institute for Mother and Child Health, Bucharest 020021, Romania
Author contributions: Balaban DV proposed the research idea; Balaban DV, Enache I, and Ciochina M performed the literature search and article selection, and drafted the initial version of the manuscript; Popp A and Jinga M critically reviewed the manuscript and supervised the project; All authors contributed to drawing the figures and tables, and have read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Daniel Vasile Balaban, MD, PhD, Senior Lecturer, Department of Internal Medicine and Gastroenterology, Carol Davila University of Medicine and Pharmacy, 134 Calea Plevnei, Bucharest 020021, Romania. vbalaban@yahoo.com
Received: January 15, 2022 Peer-review started: January 15, 2022 First decision: April 12, 2022 Revised: April 17, 2022 Accepted: May 27, 2022 Article in press: May 27, 2022 Published online: June 28, 2022
Abstract
Celiac disease (CD) is well recognized as a systemic, chronic autoimmune disease mainly characterized by gluten-sensitive enteropathy in genetically predisposed individuals but with various extraintestinal features. One of the affected organs in CD is the pancreas, consisting of both endocrine and exocrine alterations. Over the last decades there has been increasing interest in the pancreatic changes in CD, and this has been reflected by a great number of publications looking at this extraintestinal involvement during the course of CD. While pancreatic endocrine changes in CD, focusing on type 1 diabetes mellitus, are well documented in the literature, the relationship with the exocrine pancreas has been less studied. This review summarizes currently available evidence with regard to pancreatic exocrine alterations in CD, focusing on risk of pancreatitis in CD patients, association with autoimmune pancreatitis, prevalence and outcomes of pancreatic exocrine insufficiency in newly diagnosed and gluten-free diet treated CD patients, and the link with cystic fibrosis. In addition, we discuss mechanisms behind the associated pancreatic exocrine impairment in CD and highlight the recommendations for clinical practice.
Core Tip: Celiac disease (CD) is currently regarded as a systemic, chronic, immune-mediated disease triggered by gluten ingestion in genetically susceptible individuals. In the last decade there has been an increasing number of publications on extraintestinal involvement during the course of CD, some of which have assessed the pancreatic changes associated with this disease. This review summarizes currently available data with respect to exocrine pancreatic changes in CD, focusing on practices for clinicians.
