Assessment of the Different Etiological and Susceptibility Markers in Patients With Pancreatitis: Investigating IG4, Cytomegalovirus, Coxsackie- Virus, Genetic Polymorphism of Vitamin D Receptor Gene
Assessment of the Different Etiological and Susceptibility Markers in Patients With Pancreatitis: Investigating IG4, Cytomegalovirus, Coxsackie- Virus, Genetic Polymorphism of Vitamin D Receptor Gene
Acute pancreatitis (AP) is a multifactorial disease. AP represents a significant number of
 hospital admissions. Most of the patients are admitted in an acute setting. Early
 identification of its etiology is an essential step toward the rational approach, both for
 its implications in the immediate therapy and the prevention of recurrence. Although often
 obvious, the etiological workup of acute pancreatitis can be challenging.
Acute pancreatitis is the most common pancreatic disorder. Although acute pancreatitis is a
 benign disease, it often progresses to a serious state, and mortality is still high.
 Autoimmune pancreatitis (AIP) was first used to describe cases of pancreatitis with narrowing
 of the pancreatic duct, enlargement of the pancreas, hyper-γ-globulinaemia, and antinuclear
 antibody (ANA) positivity serologically by indirect immunofluorescence (IIF). The main
 differential diagnosis is pancreatic cancer, which can be ruled out through radiological,
 serological, and histological investigations.

 Cytomegalovirus (CMV) is a common viral pathogen in humans. It is a lytic virus that causes a
 cytopathic effect in vitro and in vivo. Seroprevalence for CMV worldwide ranges from 60%-100%
 but the severity of illness varies. Primary CMV may be asymptomatic or may cause a mild and
 self-limiting mononucleosis-like syndrome. The self-limiting course of CMV infection
 typically includes fever, malaise, splenomegaly, mild hepatomegaly, small increases in serum
 transaminase activity, and variable elevation of serum alkaline phosphatase. CMV infection
 can cause severe hepatitis, meningitis, encephalitis, myelitis, colitis, pancreatitis and
 pneumonitis. Coxsackie-B virus can also cause acute pancreatitis.

 VDR are also expressed on pancreatic Ɓ cells, and may play an essential role in maintaining
 normal insulin levels in accordance to glucose concentrations and to maintain glucose
 tolerance. Because vitamin D acts through VDR, their impairment or reduced functionality,
 e.g., as a result of polymorphisms occurring in the VDR gene, may have a crucial impact on
 the balance in the vitamin D concentration in the circulation, and the final metabolite
 activity throughout the body.
Inclusion Criteria:

 -  Patients with a confirmed diagnosis of acute pancreatitis.

 -  Patients of age 20 years or more who are willing to participate in the study and give
 their consent for same.

 Exclusion Criteria:

 -  with a history of severe liver disease,

 -  sepsis

 -  Chest disease.