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Volume 349:2171-2172 November 27, 2003 Number 22
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Case 27-2003: A 36-Year-Old Man with Recurrent Epigastric Pain and Elevated Amylase Levels

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 by Fernández-del Castillo, C. F.
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To the Editor: In Case 27-2003 (Aug. 28 issue),1 a patient with two rare diseases — lymphoplasmacytic sclerosing pancreatitis and amyotrophic lateral sclerosis — is described. The pathological discussion concludes with the statement that these two diseases are unrelated, but as William Osler emphasized more than a century ago, the astute clinician should attempt to find a single explanation for all the symptoms. Could both illnesses have had a single underlying cause? Lymphoplasmacytic sclerosing pancreatitis has been described as autoimmune pancreatitis, and it has been suggested that autoimmunity is a cause of amyotrophic lateral sclerosis.2 Viruses can cause pancreatitis and . . . [Full Text of this Article]




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