Gullo syndrome, also known as benign pancreatic hyperenzymemia, is characterized by the abnormal elevation of the serum levels of most or all of the pancreatic enzymes without any evidence of underlying pancreatic pathology. It is a diagnosis of exclusion made when all other laboratory assays and imaging studies are unremarkable 7.
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Epidemiology
Most commonly found in adults, men more than women, 1.5:1. It has been seen in children 7.
Clinical presentation
Individuals are asymptomatic since they lack any underlying pancreatic disease.
Pathology
Its cause remains unknown. It has been described in both sporadic and familial forms.
Markers
By definition of the disease, serum amylase and lipase levels will be elevated three times the upper limit of normal for a period of over one year. Variations in the levels of the enzymes can occur from day-to-day, and in some patients may fall into the 'normal' range.
Radiographic features
Benign pancreatic hyperenzymemia is a diagnosis of exclusion and by definition all imaging of the pancreas, including the ductal system, will be normal.
Treatment and prognosis
It has been suggested that the patient is followed up for one to two years to ensure that no evidence of pancreatic pathology arises nor any symptoms, usually coupled with normal serial imaging investigations, such as ultrasound, CT and MRCP. At this point the patient and their family may be reassured that nothing serious is underlying the hyperenzymemia 6.
History and etymology
The syndrome was first described by Lucio Gullo (1938-2009) 4, a renowned Italian pancreatologist, in 1996 3.
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