Hyderabad City doctors unravel the mystery behind tropical calcific pancreatitis (TCP)

2011

Syed Akbar

Hyderabad, March 4: City doctors have unravelled the mystery behind tropical calcific pancreatitis (TCP) by linking it to mutations in a gene called SPINK1. Tropical calcific pancreatitis is characterised by formation of calcium in pancreas, leading to diabetes and pancreatic cancer.

Doctors at the Asian Institute of Gastroenterology led by Dr D Nageshwar Reddy found that chronic pancreatitis is caused among South Indians due to mutations in SPINK1 gene. The mutation has been found in people living in Andhra Pradesh, Karnataka, Kerala, Tamil Nadu and Odisha.

Chronic pancreatitis or TCP is responsible for 50 per cent of diabetic cases. Thanks to the mutation in the SPINK1 gene, South India has got the dubious distinction of being the diabetes capital of the world. About 15 per cent of people down the Vindhyas are diabetic.

"Pancreas produces enzymes, which are quiet when they are inside it. They become active when they reach the digestive tract. But because of the mutations in SPINK1 gene, the enzymes become active in the pancreas itself resulting in auto-digestion and subsequent health complications including diabetes. We have found that one in 1000 people carry this mutant gene. Calcium is deposited in the pancreas due to the mutation," Dr Nageshwar Reddy observed.

Dr Nageshwar Reddy, who carried out the research along with Dr Siva Prasad, said the problem is characterised by recurrent stomach pain and if proper treatment is not given, it may lead to severe health complications. The problem can be avoided by staying away from alcohol, smoking and fatty food. Intake of more fruits and vegetables will also prevent the problem.

TCP has been described as a disease with “pain in childhood, diabetes in puberty and death at the prime of life.” The problem was earlier seen only in children, adolescents, or sometimes young adults, who had common characteristics of malnutrition, deficiency signs, pot belly among others.

He said the clinical manifestations of TCP are recurrent abdominal pain in childhood, followed by onset of diabetes mellitus a few years later. Prevalence of pancreatic calculi in TCP is nearly 90 per cent, compared with the 30 per cent of alcoholic pancreatitis.