Acute and recurrent pancreatitis in children: exploring etiological factors

Minen, Federico; Cunto, Angela De; Martelossi, Stefano; Ventura, Alessandro

doi:10.3109/00365521.2012.729084

Cited by 24 publications

(24 citation statements)

References 17 publications

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“…8,12 Gallstones were not exclusively associated with the overweight or haemolytic diseases, as 5 out of 12 cases had no recognised risk factors. The proportion of gallstone cases in our study (13%) was comparable to recent studies from France (13%), 23 and America (12%), 24 and higher than in Italy (6%), 25 but less than the 26% reported in another large American study. 4 We found trauma and mumps, previously the most commonly reported associations in the UK, One explanation might be that children these days are overly protected by their parents, less active, and spend more time sitting watching TV or playing electronic games than being outdoors.…”

Section: Discussionsupporting

confidence: 76%

“…[23][24][25] Seven of the children (7%) in our study who had recurrent episode/s were diagnosed with hereditary pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

“…This is similar to previous paediatric findings. 2,24,25 Asparaginase-associated pancreatitis has been reported in 6.7-18% of cases following leukaemia treatment in children, 33 but the risk was only 1.5% in children and young adults with acute lymphoblastic leukaemia in the UK. 34 Gallstones were the second most frequent association, accounting for 13% of the total patients, compared to 4% in a previous study in Scotland, 13 and no cases in other UK series.…”

Section: Discussionmentioning

confidence: 99%

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Incidence and Clinical Associations of Childhood Acute Pancreatitis

et al. 2016

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms Financial Disclosure: The authors have no financial relationships relevant to this article to disclose. Conflict of Interest:The authors have no conflicts of interest relevant to this article to disclose. What's Known on This Subject: Acute pancreatitis in childhood is a relatively rare but potentially serious condition. In the past, trauma and mumps have been the commonest associations. No study has ever estimated incidence within a childhood population on a prospective basis. AbbreviationsWhat This Study Adds: Acute pancreatitis has a childhood incidence in the UK of 0.78 per 100,000/year (95%CI 0.62-0.96). Gallstones and drug therapy are now the most commonly identified associations whilst mumps and trauma are identified rarely. Children of Pakistani heritage are disproportionately affected. Contributors' Statements:Abdalmonem Majbar: Dr Majbar helped with designing the data collection instruments, collected the data, conducted all analyses, drafted the initial manuscript, and approved the final manuscript as submitted.Eleri Cusick and Paul Johnson: Ms Cusick and Professor Johnson contributed to study conceptualization and design, took part in data interpretation, critically reviewed the manuscript, and approved the final manuscript as submitted.Richard Lynn: Mr Lynn contributed to study conceptualization and design, critically reviewed the manuscript, and approved the final manuscript as submitted.Linda Hunt: Dr Hunt supported and contributed to the statistical analysis, critically reviewed the manuscript, and approved the final manuscript as submitted.Julian Shield: Professor Shield conceptualized and designed the study, supervised and assisted data collection and analyses, critically reviewed the manuscript, and approved the final manuscript as submitted.All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. Results: 94 cases (48 boys) fulfilled the diagnostic criteria. The median age at diagnosis was 11.2 years (range 1.3-14.9). White children accounted for 61% of the cases compared to 28% from Asian and 5% from African ethnicities. Pakistani children accounted for 18 of 26 (69%) Asian patients and 19% of the total cohort. The incidence of AP in children in the UK was 0.78 per 100,000/year (95%CI 0.62-0.96). The incidence in Pakistani children (4.55; 95%CI 2.60-7.39) was 7-fold greater than White children (0.63; 95%CI 0.47-0.83). Of the 94 cases: 35 (37%) were idiopathic or associated with drugs 18 (19%), gallstones 12 (13%), hereditary 7 (7%), organic acidaemias 7 (7%), anatomical anomalies 5 (5%), viral infections 3 (3%), systemic diseases 2 (2%) and trauma 1 (1%). The most common drug associations were asparaginase (28%), azathioprine (17%) and sodium valproate (17%). Conclusions:Whilst still relatively uncommon in the U...

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Section: Discussionsupporting

confidence: 76%

“…[23][24][25] Seven of the children (7%) in our study who had recurrent episode/s were diagnosed with hereditary pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Incidence and Clinical Associations of Childhood Acute Pancreatitis

et al. 2016

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“…The results of this pediatric sample show that pancreatitis can have multiple and complex etiologies in children. Among the diverse range of etiologies of pediatric AP, gallstones and biliary disease seem to play a greater role than previously thought [1,2,10,11,[19][20][21]. In this report, it was also the most common (24.3%) etiological cause.…”

Section: Resultsmentioning

confidence: 52%

Acute pancreatitis in children: a tertiary hospital report

Antunes

Nascimento

Mesquita

et al. 2014

Scandinavian Journal of Gastroenterology

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Introduction. The incidence of acute pancreatitis (AP) in children has increased significantly in the past two decades. Objective. All cases of AP, acute recurrent pancreatitis (ARP), and chronic pancreatitis examined between May 2002 and May 2012 at Hospital de Braga, Portugal, were reviewed. Material and methods. Patients were identified by searching the hospital's electronic discharge records for the International Classification of Disease, Ninth Revision (ICD-9) code 577.0 (acute pancreatitis). ARP was considered as two or more episodes of AP per year or more than three episodes over a lifetime with intervening return to baseline. The following data were analyzed: demographic information, clinical, laboratory and imaging test results, etiology of pancreatitis, medical and surgical management, length of hospitalization, and outcome. The clinical and laboratory factors used in the pediatric acute pancreatitis severity score system and computed tomography severity index (CTSI) score were compared between patients with mild and severe disease. Results. A total of 37 patients, 31 episodes of AP and 6 patients with ARP, were documented. The most prevalent etiologies were biliary stones/sludge (24.3%) and trauma (16.2%). Admission elevated white blood cell count (p = 0.011), 48-h trough calcium (p = 0.007), and 48-h rise in blood urea nitrogen (p = 0.025) correlated significantly with disease severity. CTSI on admission had a score below 4 in three patients with severe disease. Conclusion. This Portuguese pediatric pancreatitis report highlights the multiple and complex etiology of this disease. Better pediatric scoring systems and management algorithms are needed.

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“…Although this finding has never been mentioned in previous reports and it is unclear whether there is a connection between hyperlipidemia and higher risk of death, we suggest that hyperlipidemia can be considered to be an independent etiology of the patients with AP in children. Besides, a high prevalence of genetic mutations (CFTR, SPINK1, PRRS1 mutations) was found in those patients without anatomic or metabolic abnormalities known to be associated with pancreatitis [29,30]. Since genetic tests are not routinely performed in the patients with idiopathic cause, it is unclear whether genetic mutation is another potential reason for the higher mortality rate of idiopathic cause.…”

Section: Discussionmentioning

confidence: 97%