PEDIATRICS Vol. 63 No. 3 March 1979, pp. 361-368
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Multifocal Myocardial Necrosis and Fibrosis in Pancreatic Diseases of Children

Christian Nezelof M.D.1 and Guy LeSec M.D.1

1 Groupe de Recherche de Pathologie pèdiatrique, U 77, Institut National de la Santè de la Recherche Mèdical, Hôpital des Enfants Malades, Paris

From a review of 2,000 autopsies of children, 16 cases of extensive necrosis and scarring fibrosis of the myocardium were found. These lesions involved mainly the left ventricle and spared the endocardium, the pericardium, and the coronary vessels. These necrotic or fibrotic heart lesions were found to be closely associated with various pancreatic diseases: cystic fibrosis (11 cases), pancreatic lipomatosis (2 cases), extensive small bowel resection (3 cases, 2 of which were associated with acute interstitial pancreatitis). To explain these unexpected associations, two hypotheses can be put forth: (1) The lack of absorption of some presently undetermined substances indispensable for the correct trophicity of the myocardium, and (2) the release in the blood of proteolytic enzymes with consecutive activation of phlogistic substances such as kinins.

Submitted on December 13, 1977
Accepted on July 26, 1978