Liver, Pancreas, and Biliary Tract: Clinical Reviews: Pancreatic and Biliary DiseaseTropical Chronic Pancreatitis: An UpdateMohan, V. M.D., M.R.C.P., Ph.D., D.Sc.; Premalatha, G. M.B.B.S., F.D.I.A.B.; Pitchumoni, C. S. M.D.Author Information From the M.V. Diabetes Specialities Center & Madras Diabetes Research Foundation Gopalapuram (V.M., G.P.), Chennai, India; and the Departments of Gastroenterology, Hepatology, and Clinical Nutrition, Saint Peter's University Hospital (C.S.P.), New Brunswick, New Jersey. Address correspondence and reprint requests to Dr. V. Mohan, M.V. Diabetes Specialities Center & Madras Diabetes Research Foundation 35, Conran Smith Road, Gopalapuram, Chennai, 600 086, India E-mail: [email protected] Journal of Clinical Gastroenterology: April 2003 - Volume 36 - Issue 4 - p 337-346 Buy SDC Abstract Tropical chronic pancreatitis represents a juvenile nonalcoholic form of chronic pancreatitis prevalent in many tropical developing countries. Tropical chronic pancreatitis differs from temperate zone pancreatitis in its younger age of onset, more accelerated course, higher prevalence of pancreatic calculi and diabetes, and greater propensity to pancreatic malignancy. The diabetic stage of the disease is referred to as fibrocalculous pancreatic diabetes. The diabetes is severe and insulin requiring although ketosis resistant. Diabetic complications occur in fibrocalculous pancreatic diabetes just like in other primary forms of diabetes. The etiology of tropical chronic pancreatitis remains unclear, although malnutrition along with dietary cyanogen toxicity, antioxidant deficiency, and a genetic predisposition have been proposed. In the last few decades, the prognosis has markedly improved as a result of better management of diabetes. Yet a better understanding of the pathogenesis of tropical chronic pancreatitis could further improve treatment options and offer an opportunity for prevention of this disorder, which leads to severe morbidity in a large proportion of affected patients. © 2003 Lippincott Williams & Wilkins, Inc.