RELAPSING pancreatitis in several members of one family was first reported in 1952 by Comfort and Steinberg.1 Since then, it has been reported in other kindred in this country 2-4 and Europe.5 The majority of the patients had attacks of severe recurrent abdominal pain beginning in early childhood, although the diagnosis was not usually established until adult life.To our knowledge, this entity has not been reported in the pediatric literature.We therefore present the occurrence of chronic pancreatitis in a young girl and her mother and review the literature.
Report of a CasePatient.\p=m-\A5-year-old white girl was referred to the Boston Floating Hospital for Infants and Children (Tufts-New England Medical Center) with the chief complaint of abdominal pain of several hours' duration. Since 2 years of age, she had had similar attacks occurring every two to four months, varying in severity, and lasting three to four days. Initial symptoms included several days of irritability, anorexia, constipation, and increased thirst, followed by vomiting and severe intermittent periumbilical and epigastric pa*n. Fever, jaundice, and ab¬ normal stools were not present. She was asymptomatic between attacks. Hospitalization and treatment with fluids given intravenously and Meperidine hydrochloride (Demerol) were necessary for most of the attacks. Serum amylase levels were elevated during attacks, reaching as high as 3.000 units.No difficulties were experienced during in¬ fancy except for frequent episodes of wheezing. Her growth and development were normal. She had pneumonia on three occasions and several episodes of urticaria of unknown etiology.Physical examination at the time of admission revealed a slender girl with flushed cheeks who was in the 10th percentile for weight and 25th percentile for height. Vital signs were normal. The examination was completely normal except for absence of bowel sounds and marked epigastric guarding and tenderness. No masses were palpable and rectal examination was nor¬ mal. Laboratory studies provided the following data: hemoglobin, 13.6 gm; hematocrit, 41%; and white blood cell count, 5,000/cu mm with 88% neutrophils. Urinalysis, blood urea nitrogen, creatinine, bilirubin, serum glutamic oxaloacetic transaminase, serum glutamic pyrivic transaminase, sodium, potassium, chloride, calcium, phosphorus, uric acid, and carbon dioxide con¬ tent were all within normal limits. Admission serum amylase was 1,180 Somogyi units (SU), dropping to 820 SU on the second hospital day and 100 SU on discharge. Serum lipase was 15.4 units. Erythrocyte sedimentation rate was 33 mm/60 min. Nose, throat, trachéal, and stool cultures were normal. An oral glucose tolerance test showed the following blood glucose levels: fasting, 87 mg/100 cc; one-half hour, 172 mg/100 cc; one hour, 174 mg/100 cc; two hours, 110 mg/ 100 cc; and three hours, 57 mg/100 cc. An electro¬ encephalogram, serum and urine amino acid patterns, sweat electrolytes, and serum immunoelectrophoresis were normal. X-ray films of the abdomen on admission ...