The role of pancreatic glucagon in the pathogenesis of acute pancreatitis.

1. A reliable, reproducible and specific method for determination of pancreatic glucagon in plasma by radioimmunoassay is described and plasma glucagon was measured in normal subjects and patients with acute pancreatitis. 2. In patients with acute pancreatitis the normal relationship between glucagon and glucose was impaired and disturbance of alpha-cell function was indicated by relative hyperglucagonaemia in patients with moderately severe disease. 3. In patients with severe pancreatitis glucagon concentrations were low and the possible relationship between hyperand hypo-glucagonaemia and the pathogenesis of acute pancreatitis is discussed. 4. Insulin values in acute pancreatitis, although increased, were not as high as would be expected for the raised glucose concentrations. 5. It is concluded that both alphaand beta-cell dysfunction may account for the high incidence of carbohydrate intolerance in acute pancreatitis.