[Medical treatment of Crohn disease].
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Biomedical subjects
Publications and source records attributed to L Descos.
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The effect of maximal doses of cholecystokinin and caerulein on lipase and chymotropsin concentrations were compared in large groups of patients with almost equal capacities of bicarbonate secretion. The responsiveness of the pancreas is, as a whole, higher with caerulein than with cholecystokinin, this feature being specially evident in patients with chronic calcifying pancreatitis.
Pancreatic function tests were performed before and after dietary therapy in four patients suffering from primitive malnutrition. Maximal bicarbonate concentrations and lipase activity were the parameters most clearly affected by malnutrition and those showing the fastest recovery following therapy. With reference to this quick recovery it seems unlikely that, at least in Western countries, malnutrition could be a cause of chronic pancreatitis. Interpretation of pancreatic function tests requires an exact knowledge of the nutritional status.
Gastric albumin clearance studies were carried out in 26 patients with alcoholic cirrhosis and in 10 control subjects. The mean clearance was significantly higher in patients than in control subjects. An increased protein gastric loss in cirrhotic patients was observed only in presence of gastritis. The presence or absence of distended esophageal varices did not influence the protein loss.
The principal clinical and biological characteristics and the origin of pruritus of pregnancy (p.p.) which occurs in a little more than two pregnancies per thousand are considered in the light of 7 cases. As with recurrent jaundice of pregnancy (r.j.p.), of which pruritus represents a minor analogue, the symptoms occur solely during pregnancy and disappear after delivery. In p.p. signs of cholestasis are seen, more marked than in a normal pregnancy coming to term but less than in icterus gravidarum. The increase in transaminases seen in p.p. and r.j.p. does not occur in normal pregnancy. The two conditions, which may be grouped together under the term hepatogestosis, are benign as far as the mother is concerned but represent a definite and significant risk of prematurity for the child. It is possible to establish a relation between p.p. and/or r.j.p. and the hepatic manifestations associated with oral contraceptives. In both instances a genetic predisposition seems to favour the development of a cholestatic syndrome. A past history of p.p. represents a contraindication to the use of oral contraceptives. Cholestyramine, a bile salt chelator, gives excellent results in persistent p.p.
By comparison with control subjects, patients with chronic pancreatitis and alcoholic liver cirrhosis displayed in basal condition a reduction in salivary volume, bicarbonate and an amylase concentration and outputs. These reductions disappeared during stimulating by chewing parafilm. It is concluded that these reductions are not the consequence of a specific process affecting both the salivary glands and the pancreas. It is suggested that they are more likely due to a decreased sensitivity of the salivary nervous control than to an actual alteration in the secretory capacities.
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