- (2009) Volume 10, Issue 2
Jay J Mast1, Marjolein JM Morak1, Bernard T Brett2, Casper HJ van Eijck1
1Department of Surgery, Erasmus Medical Centre. Rotterdam, The Netherlands
2Department of Gastroenterology, James Page University Hospitals NHS Foundation Trust. Norfolk, England, United Kingdom
Received March 2nd, 2009
Dear Sir
We agree with Dr. Löhr and Dr. Sandberg [1] that more unusual causes of acute necrotizing pancreatitis should be sought in this particular patient. Although atherosclerotic microangiopathy is less expected in an experienced marathon runner, genetic causes of pancreatitis should be considered. However, since this patient lives in the United Kingdom, we did not search for genetic factors influencing the development of pancreatitis. A recommendation for further genetic counselling after discharge was made.
Concerning hemoconcentration, a hemoglobulin level of 10.7 mmol/L (reference range: 8.6-10.5 mmol/L) and a hematocrit of 47% (reference range: 40-50%) were observed. Furthermore, the urea level in our patient was 9.9 mmol/L (reference range: 2.5-7.5 mmol/L) at admission which was also related to dehydration. The hemoglobulin level decreased to 8.3 mmol/L and the hematocrit to 39% after 2 liters of natrium-chloride infusion.
With regards
Jay J Mast
Marjolein JM Morak
Bernard T Brett
Casper HJ van Eijck
The authors have no potential conflicts of interest
