Abstract：
Pancreatic exocrine insufficiency (PEI) is an under-diagnosed condition. Untreated PEI can result in developing gastrointestinal symptoms and long-term complications including weight loss, nutrient deficiencies, sarcopenia and osteoporosis. Current best practice recommends testing for PEI in certain disorders including chronic pancreatitis, cystic fibrosis, pancreatic cancer and post-pancreatic surgery. However, there is increasing evidence that PEI is associated with a number of conditions in addition to the aforementioned diseases. These \'at-risk\' conditions are a heterogeneous group of diseases, for example, diabetes mellitus, people living with human immunodeficiency virus, high alcohol intake, and coeliac disease. The pathophysiology of some of \'at-risk\' conditions is becoming increasingly recognised; therefore, the list of associated conditions are in evolving process. We present a case of a 60-year-old male with Parkinson\'s disease and persistent abdominal pain who was found to have low faecal elastase levels indicative of severe PEI. His past medical history included none of the known risk factors for PEI. After examining the literature, we report a similar pathophysiological process underlying the development of pancreatitis and Parkinson\'s disease which is dysfunction of the Unfolded Protein Response. We suggest further research to assess the prevalence of PEI in the population of patients with Parkinson\'s disease.
摘要：
胰腺外分泌功能不全(PEI)是一种未被诊断的病症。未经治疗的PEI可导致出现胃肠道症状和长期并发症，包括体重减轻。营养缺乏,肌肉减少症和骨质疏松症。目前的最佳实践建议在某些疾病中测试PEI，包括慢性胰腺炎，囊性纤维化,胰腺癌和胰腺手术后。然而,越来越多的证据表明,除了上述疾病外,PEI还与多种疾病有关.这些“高危”疾病是一组异质性疾病，例如,糖尿病,患有人类免疫缺陷病毒的人，高酒精摄入量，还有乳糜泻.一些“高危”病症的病理生理学越来越被人们认识到；因此，相关条件列表正在演变过程中。我们介绍了一例患有帕金森氏病和持续性腹痛的60岁男性，发现其粪便弹性蛋白酶水平低，表明严重的PEI。他的既往病史不包括任何已知的PEI危险因素。在研究了文献之后，我们报道了一个类似的病理生理过程，作为胰腺炎和帕金森病发展的基础，它是未折叠蛋白反应的功能障碍。我们建议进一步研究以评估帕金森病患者人群中PEI的患病率。
