Chronic Asymptomatic Pancreatic Hyperenzymemia: A Long-term Follow-up

Objectives:Chronicasymptomaticpancreatichyperenzymemia(CAPH) was describedas a benigndisease. However,we already describedclinically relevant findings requiring surgery or follow-up in half of the subjects. The aimofthisstudywastoevaluatethelong-termoutcomeofCAPHinterms of symptoms and evolution toward chronic pancreatitis. Methods: Subjects previously enrolled in the first phase of the study (from 2005 to 2010) were reinvestigated from December 2013 to January 2017withaphonecall±magneticresonancecholangiopancreatographywith secretin stimulation. Results:Atotalof133subjectswereeligibleforthefollow-upstudy(75males, 58 females; age, 48.4 [standard deviation {SD}, 14] years); 24 (18%) of them dropped out. During a mean follow-up of 9.3 (SD, 5.2) years after thefirstdiagnosisofCAPH,noepisodeofacutepancreatitisorabdominal pain was reported. Sixty-three subjects (58%) of 109 underwent magnetic resonance cholangiopancreatography with secretin stimulation with a mean follow-up of 5.7 [SD, 3.1] years (range, 1–11 years). Secretin stimulationMRCP resulted unchanged in 54 (90%) of 60 subjects, worsened in 3 (5%) and improved in 3 (5%). Two subjects died from causes unrelated to pancreatic disease. Conclusions:Excludingsubjectswithapancreaticdiseaseatindexmagnetic resonance imaging, CAPH is a benign condition.