{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:48:12Z","timestamp":1777312092196,"version":"3.51.4"},"reference-count":54,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:p>Mycobacterium tuberculosis (TB) disease is a major global health problem affecting 10.6 million people worldwide, and India alone contributes 28% to this burden. Pancreatic TB is considered an extremely rare entity which closely mimics pancreatic carcinoma. However, while 87% of the total globally notified TB cases are from 30 high-burden countries mostly from Asia, about 45% of pancreatic TB cases are from developed countries. This suggests that the identified cases of pancreatic TB in developing counties are just the tip of iceberg, and many cases either remain undetected or wrongly diagnosed. The majority of the patients with pancreatic TB undergo extensive evaluation and frequently undergo major abdominal surgeries since pancreatic carcinoma is often considered as the most probable diagnosis before TB. Here, 2 cases of pancreatic TB managed separately at two different centers are described. Both cases presented with significant unintentional weight loss and poor glycemic control which is an unusual presentation for pancreatic TB. Imaging showed pancreatic mass lesions, and initially pancreatic carcinoma was considered by the treating physicians. Chromogranin A in both patients and tumor markers done in one of the patients were negative. Both the patients underwent Ga-68 DOTANOC PET\/CT scan, and one of the patients even showed multiple DOTANOC avid lesions. Owing to contradictory biochemical and imaging findings, biopsy of the pancreatic mass was done which clinched the diagnosis of pancreatic TB. On starting standard anti-tubercular therapy (ATT), both patients showed clinical and radiological recovery with a significant regain of glycemic control. The clinical features, appropriate investigation including imaging and tissue biopsy, and treatment options are described in the article for better understanding of the disease. This may guide clinicians in early detection of pancreatic TB with least invasive diagnostic procedures.<\/jats:p>","DOI":"10.5339\/qmj.2024.54","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T03:50:43Z","timestamp":1736394643000},"source":"Crossref","is-referenced-by-count":1,"title":["Two cases of pancreatic tuberculosis in immunocompetent individuals presenting as diabetes mellitus: An overview of clinical features, diagnosis and management"],"prefix":"10.5339","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3113-1284","authenticated-orcid":true,"given":"G","family":"Varadaraj","sequence":"first","affiliation":[{"name":"Army College of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avantika","family":"Rai","sequence":"additional","affiliation":[{"name":"12 Air Force Hospital, Gorakhpur, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parthasarathi","family":"Ghana","sequence":"additional","affiliation":[{"name":"Air Force Central Medical Establishment, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiran","family":"Maribashetti","sequence":"additional","affiliation":[{"name":"155 Base Hospital, Tezpur, India*Correspondence: G Varadaraj flt.lt.varad@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"key":"CIT0001","article-title":"Ministry of Health and Family Welfare Government of India;","year":"2023"},{"key":"CIT0002","article-title":"Global tuberculosis report","year":"2018"},{"issue":"(6):","key":"CIT0003","series-title":"Indian J Surg","first-page":"517\u201324","article-title":"Pancreatic tuberculosis","volume":"77","author":"Chaudhary\n \nP","year":"2015"},{"issue":"(4):","key":"CIT0004","series-title":"United European Gastroenterol J","first-page":"396\u2013402","article-title":"Pancreatic tuberculosis: A systematic review of symptoms, diagnosis and treatment","volume":"8","author":"Panic\n \nN","year":"2020"},{"issue":"(3):","key":"CIT0005","series-title":"J Pancreas (Online)","first-page":"232\u20138","article-title":"Pancreatic tuberculosis: An overview","volume":"16","author":"Shabnam\n \nS","year":"2015"},{"issue":"(4):","key":"CIT0006","series-title":"Ann Gastroenterol","first-page":"395\u20138","article-title":"Vascular invasion does not discriminate between pancreatic tuberculosis and pancreatic malignancy: A case series","volume":"27","author":"Rana\n \nSS","year":"2014;"},{"issue":"(4):","key":"CIT0007","series-title":"Abdom Imaging","first-page":"394\u20137","article-title":"Pancreatic tuberculosis: CT findings","volume":"23","author":"Pombo\n \nF","year":"1998"},{"issue":"(2):","key":"CIT0008","series-title":"J Endocrinol","first-page":"337\u201341","article-title":"A comparison between three commercial kits for Chromogranin A measurements","volume":"177","author":"Stridsberg\n \nM","year":"2003"},{"issue":"(1):","key":"CIT0009","series-title":"Arch Med Sci","first-page":"1\u20139","article-title":"Chromogranin A\u2014unspecific neuroendocrine marker. Clinical utility and potential diagnostic pitfalls","volume":"12","author":"Gut\n \nP","year":"2016"},{"issue":"(2):","key":"CIT0010","series-title":"J Dig Dis","first-page":"105\u20138","article-title":"Isolated peripancreatic tuberculous lymphadenopathy: A rare manifestation of abdominal tuberculosis mimicking pancreatic cystic neoplasm","volume":"14","author":"Huang\n \nCT","year":"2013"},{"issue":"(1):","key":"CIT0011","series-title":"Indian J Nucl Med","first-page":"29\u201336","article-title":"Role of Ga-68 DOTANOC Positron Emission Tomography\/Computed Tomography Scan in Clinical Management of Patients with Neuroendocrine Tumors and its Correlation with Conventional Imaging-Experience in a Tertiary Care Center in India","volume":"37","author":"Singh\n \nD","year":"2022"},{"issue":"(7):","key":"CIT0012","series-title":"J Nucl Med","first-page":"1054\u20137","article-title":"Localization of unknown primary site with Ga-DOTANAOC PET\/CT in patients with metastatic neuroendocrine tumor","volume":"58","author":"Menda\n \nY","year":"2017"},{"issue":"(2):","key":"CIT0013","series-title":"Clin Infect Dis","first-page":"111\u20135","article-title":"Official American Thoracic Society\/Infectious Diseases Society of America\/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children","volume":"64","author":"Lewinsohn\n \nDM","year":"2017"},{"issue":"(3 Pt 1):","key":"CIT0014","series-title":"Gastrointest Endosc","first-page":"484\u201391","article-title":"Yield of EUS-guided FNA on the diagnosis of pancreatic\/peripancreatic tuberculosis","volume":"69","author":"Song\n \nTJ","year":"2009"},{"issue":"(2):","key":"CIT0015","series-title":"Endosc Ultrasound","first-page":"77\u201385","article-title":"Endoscopic ultrasound-guided fine needle aspiration: From the past to the future","volume":"2","author":"Costache\n \nMI","year":"2013"},{"issue":"(3):","key":"CIT0016","series-title":"Ann Gastroenterol","first-page":"207\u201311","article-title":"Hepatobiliary tuberculosis","volume":"27","author":"Chaudhary\n \nP","year":"2014;"},{"issue":"(1):","key":"CIT0017","series-title":"J Comput Assist Tomogr","first-page":"136\u201341","article-title":"Pancreatic tuberculosis: A clinical and imaging review of 32 cases","volume":"33","author":"Nagar\n \nAM","year":"2009"},{"issue":"(5):","key":"CIT0018","series-title":"World J Clin Cases","first-page":"181\u20136","article-title":"Fine needle aspiration diagnosis of isolated pancreatic tuberculosis: A case report","volume":"1","author":"Sonthalia\n \nN","year":"2013"},{"issue":"(2):","key":"CIT0019","series-title":"J Cytol","first-page":"130\u20135","article-title":"Pancreatic and peripancreatic tuberculosis presenting as hypoechoic mass and malignancy diagnosed by ultrasound-guided fine-needle aspiration cytology","volume":"30","author":"Rao\n \nRN","year":"2013"},{"issue":"(4):","key":"CIT0020","series-title":"Ann Oncol","first-page":"725\u201331","article-title":"European cancer mortality predictions for the year 2016 with focus on leukaemias","volume":"27","author":"Malvezzi\n \nM","year":"2016"},{"issue":"(1):","key":"CIT0021","series-title":"Mol Carcinog","first-page":"3\u201313","article-title":"Pancreatic cancer: overview of descriptive epidemiology","volume":"51","author":"Bosetti\n \nC","year":"2012"},{"issue":"(7):","key":"CIT0022","series-title":"PLoS Med","first-page":"e152","article-title":"Diabetes mellitus increases the risk of active tuberculosis: A systematic review of 13 observational studies","volume":"5","author":"Jeon\n \nCY","year":"2008"},{"issue":"(2):","key":"CIT0023","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"97\u2013103","article-title":"The role of interferon-gamma in the increased tuberculosis risk in type 2 diabetes mellitus","volume":"27","author":"Stalenhoef\n \nJE","year":"2008"},{"issue":"(9):","key":"CIT0024","series-title":"J Assoc Physicians India","first-page":"938\u20139","article-title":"Diabetes mellitus: An uncommon manifestation of pancreatic tuberculosis","volume":"47","author":"Patankar\n \nT","year":"1999"},{"issue":"(3):","key":"CIT0025","series-title":"Indian J Med Microbiol","first-page":"259\u201360","article-title":"Isolated pancreatic tuberculosis","volume":"27","author":"Pandita\n \nKK","year":"2009"},{"issue":"(5):","key":"CIT0026","series-title":"West J Med","first-page":"432\u20136","article-title":"Pancreatitis as the presenting manifestation of miliary tuberculosis","volume":"129","author":"Rushing\n \nJL","year":"1978"},{"issue":"(4):","key":"CIT0027","series-title":"Apollo Med","first-page":"287\u201391","article-title":"Abdominal tuberculosis: Current status","volume":"4","author":"Bhargava\n \nD","year":"2007"},{"key":"CIT0001","article-title":"Ministry of Health and Family Welfare Government of India;","year":"2023"},{"key":"CIT0002","article-title":"Global tuberculosis report","year":"2018"},{"issue":"(6):","key":"CIT0003","series-title":"Indian J Surg","first-page":"517\u201324","article-title":"Pancreatic tuberculosis","volume":"77","author":"Chaudhary\n \nP","year":"2015"},{"issue":"(4):","key":"CIT0004","series-title":"United European Gastroenterol J","first-page":"396\u2013402","article-title":"Pancreatic tuberculosis: A systematic review of symptoms, diagnosis and treatment","volume":"8","author":"Panic\n \nN","year":"2020"},{"issue":"(3):","key":"CIT0005","series-title":"J Pancreas (Online)","first-page":"232\u20138","article-title":"Pancreatic tuberculosis: An overview","volume":"16","author":"Shabnam\n \nS","year":"2015"},{"issue":"(4):","key":"CIT0006","series-title":"Ann Gastroenterol","first-page":"395\u20138","article-title":"Vascular invasion does not discriminate between pancreatic tuberculosis and pancreatic malignancy: A case series","volume":"27","author":"Rana\n \nSS","year":"2014;"},{"issue":"(4):","key":"CIT0007","series-title":"Abdom Imaging","first-page":"394\u20137","article-title":"Pancreatic tuberculosis: CT findings","volume":"23","author":"Pombo\n \nF","year":"1998"},{"issue":"(2):","key":"CIT0008","series-title":"J Endocrinol","first-page":"337\u201341","article-title":"A comparison between three commercial kits for Chromogranin A measurements","volume":"177","author":"Stridsberg\n \nM","year":"2003"},{"issue":"(1):","key":"CIT0009","series-title":"Arch Med Sci","first-page":"1\u20139","article-title":"Chromogranin A\u2014unspecific neuroendocrine marker. Clinical utility and potential diagnostic pitfalls","volume":"12","author":"Gut\n \nP","year":"2016"},{"issue":"(2):","key":"CIT0010","series-title":"J Dig Dis","first-page":"105\u20138","article-title":"Isolated peripancreatic tuberculous lymphadenopathy: A rare manifestation of abdominal tuberculosis mimicking pancreatic cystic neoplasm","volume":"14","author":"Huang\n \nCT","year":"2013"},{"issue":"(1):","key":"CIT0011","series-title":"Indian J Nucl Med","first-page":"29\u201336","article-title":"Role of Ga-68 DOTANOC Positron Emission Tomography\/Computed Tomography Scan in Clinical Management of Patients with Neuroendocrine Tumors and its Correlation with Conventional Imaging-Experience in a Tertiary Care Center in India","volume":"37","author":"Singh\n \nD","year":"2022"},{"issue":"(7):","key":"CIT0012","series-title":"J Nucl Med","first-page":"1054\u20137","article-title":"Localization of unknown primary site with Ga-DOTANAOC PET\/CT in patients with metastatic neuroendocrine tumor","volume":"58","author":"Menda\n \nY","year":"2017"},{"issue":"(2):","key":"CIT0013","series-title":"Clin Infect Dis","first-page":"111\u20135","article-title":"Official American Thoracic Society\/Infectious Diseases Society of America\/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children","volume":"64","author":"Lewinsohn\n \nDM","year":"2017"},{"issue":"(3 Pt 1):","key":"CIT0014","series-title":"Gastrointest Endosc","first-page":"484\u201391","article-title":"Yield of EUS-guided FNA on the diagnosis of pancreatic\/peripancreatic tuberculosis","volume":"69","author":"Song\n \nTJ","year":"2009"},{"issue":"(2):","key":"CIT0015","series-title":"Endosc Ultrasound","first-page":"77\u201385","article-title":"Endoscopic ultrasound-guided fine needle aspiration: From the past to the future","volume":"2","author":"Costache\n \nMI","year":"2013"},{"issue":"(3):","key":"CIT0016","series-title":"Ann Gastroenterol","first-page":"207\u201311","article-title":"Hepatobiliary tuberculosis","volume":"27","author":"Chaudhary\n \nP","year":"2014;"},{"issue":"(1):","key":"CIT0017","series-title":"J Comput Assist Tomogr","first-page":"136\u201341","article-title":"Pancreatic tuberculosis: A clinical and imaging review of 32 cases","volume":"33","author":"Nagar\n \nAM","year":"2009"},{"issue":"(5):","key":"CIT0018","series-title":"World J Clin Cases","first-page":"181\u20136","article-title":"Fine needle aspiration diagnosis of isolated pancreatic tuberculosis: A case report","volume":"1","author":"Sonthalia\n \nN","year":"2013"},{"issue":"(2):","key":"CIT0019","series-title":"J Cytol","first-page":"130\u20135","article-title":"Pancreatic and peripancreatic tuberculosis presenting as hypoechoic mass and malignancy diagnosed by ultrasound-guided fine-needle aspiration cytology","volume":"30","author":"Rao\n \nRN","year":"2013"},{"issue":"(4):","key":"CIT0020","series-title":"Ann Oncol","first-page":"725\u201331","article-title":"European cancer mortality predictions for the year 2016 with focus on leukaemias","volume":"27","author":"Malvezzi\n \nM","year":"2016"},{"issue":"(1):","key":"CIT0021","series-title":"Mol Carcinog","first-page":"3\u201313","article-title":"Pancreatic cancer: overview of descriptive epidemiology","volume":"51","author":"Bosetti\n \nC","year":"2012"},{"issue":"(7):","key":"CIT0022","series-title":"PLoS Med","first-page":"e152","article-title":"Diabetes mellitus increases the risk of active tuberculosis: A systematic review of 13 observational studies","volume":"5","author":"Jeon\n \nCY","year":"2008"},{"issue":"(2):","key":"CIT0023","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"97\u2013103","article-title":"The role of interferon-gamma in the increased tuberculosis risk in type 2 diabetes mellitus","volume":"27","author":"Stalenhoef\n \nJE","year":"2008"},{"issue":"(9):","key":"CIT0024","series-title":"J Assoc Physicians India","first-page":"938\u20139","article-title":"Diabetes mellitus: An uncommon manifestation of pancreatic tuberculosis","volume":"47","author":"Patankar\n \nT","year":"1999"},{"issue":"(3):","key":"CIT0025","series-title":"Indian J Med Microbiol","first-page":"259\u201360","article-title":"Isolated pancreatic tuberculosis","volume":"27","author":"Pandita\n \nKK","year":"2009"},{"issue":"(5):","key":"CIT0026","series-title":"West J Med","first-page":"432\u20136","article-title":"Pancreatitis as the presenting manifestation of miliary tuberculosis","volume":"129","author":"Rushing\n \nJL","year":"1978"},{"issue":"(4):","key":"CIT0027","series-title":"Apollo Med","first-page":"287\u201391","article-title":"Abdominal tuberculosis: Current status","volume":"4","author":"Bhargava\n \nD","year":"2007"}],"container-title":["Qatar Medical Journal"],"original-title":[],"link":[{"URL":"https:\/\/www.qscience.com\/view\/journals\/qmj\/2024\/4\/article-54.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.qscience.com\/downloadpdf\/journals\/qmj\/2024\/4\/article-54.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.qscience.com\/downloadpdf\/journals\/qmj\/2024\/4\/article-54.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:11:58Z","timestamp":1777309918000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.qscience.com\/view\/journals\/qmj\/2024\/4\/article-54.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":54,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.5339\/qmj.2024.54","relation":{},"ISSN":["2227-0426"],"issn-type":[{"value":"2227-0426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024]]}}}