The nutritional status and factors contributing to malnutrition in children with chronic pancreatitis

Kołodziejczyk, Elwira; Wejnarska, Karolina; Dądalski, Maciej; Kierkuś, Jarosław; Ryżko, Józef; Oracz, Grzegorz

doi:10.1016/j.pan.2014.04.030

Cited by 22 publications

(23 citation statements)

References 22 publications

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“…will invariably lead to exocrine pancreatic insufficiency (EPI) and diabetes. If EPI develops, children may develop steatorrhea, weight loss, and fat-soluble vitamin deficiencies (vitamins A, D, E, and K), and these changes retard the growth and development of children [5]. Our study revealed that the height of the boys pre-ESWL was significantly lower than the standard heights for their ages (P = 0.009), and similar results were noted for the girls (P < 0.001).…”

Section: Pediatric Group (N = 72)supporting

confidence: 73%

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Extracorporeal shock wave lithotripsy is safe and effective for pediatric patients with chronic pancreatitis

Wang

et al. 2017

Endoscopy

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Chronic pancreatitis is characterized by pancreatic inflammation and fibrosis, which eventually leads to the destruction of the pancreatic parenchyma and loss of both exocrine and endocrine function. Recent studies have estimated that the incidence of chronic pancreatitis in children is approximately 0.5 per 100 000 per year [1-3]. Despite this modest incidence rate, the disease burden of chronic pancreatitis in pediatric patients is substantial owing to the extreme disruption caused to the patients' childhood and education. Children with chronic pancreatitis typically suffer from chronic or severe relapsing abdominal pain, with frequent emergency department visits, hospitalizations, and Extracorporeal shock wave lithotripsy is safe and effective for pediatric patients with chronic pancreatitis

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Section: Pediatric Group (N = 72)supporting

confidence: 73%

“…school absences [4]. Moreover, malnutrition caused by decreased dietary intake and malabsorption is known to retard the growth and development of these children [5].…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal shock wave lithotripsy is safe and effective for pediatric patients with chronic pancreatitis

Wang

et al. 2017

Endoscopy

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“…Data from the INSPPIRE cohort has shown that one third of children with CP have exocrine pancreatic insufficiency (EPI)(74), and a Polish study has demonstrated that 25% of children with CP have malnutrition (75).…”

Section: Methodsmentioning

confidence: 99%

Nutritional Considerations in Pediatric Pancreatitis

Abu‐El‐Haija

Uç

Werlin

et al. 2018

J. pediatr. gastroenterol. nutr.

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This document presents the first authoritative recommendations on nutritional considerations in pediatric pancreatitis. Future research should address the gaps in knowledge particularly relating to optimal nutrition for AP in children, role of diet or dietary supplements on recurrent attacks of pancreatitis and pain episodes, monitoring practices to detect early growth and nutritional deficiencies in CP and identifying risk factors that predispose children to these deficiencies.

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“…Chronic pancreatitis (CP) and acute recurrent pancreatitis (ARP) reflect repeated episodes of inflammation of the pancreas, ultimately leading to end organ damage representing parenchymal loss, fibrosis, and decreased exocrine and/or endocrine pancreatic function [1]. Exocrine pancreatic insufficiency (EPI) can have serious sequelae including malnutrition, bone disease, and growth failure if not promptly diagnosed and treated [2]. Unfortunately, diagnosing CP and EPI early and accurately remains a challenge but is critical to allow early intervention with medications, endoscopic therapies, or surgery.…”

Section: Introductionmentioning

confidence: 99%

3D MR elastography of the pancreas in children

2019

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Purpose-Early diagnosis of chronic pancreatitis (CP) remains elusive. Preliminary data suggest that MR elastography (MRE) may have diagnostic value in the identification of CP. We sought to measure pancreas stiffness by MRE in healthy children and to compare measured values to stiffness values in pediatric patients with acute recurrent pancreatitis (ARP) or CP.Methods-Under IRB approval, 49 healthy controls volunteered to be included, and 14 patients with ARP or CP that underwent 3D MRE on a 1.5T MR scanner were included in the study. A soft passive driver was utilized and vibrated at 40 Hz. Regions of interest for measurement of pancreatic stiffness were drawn by two blinded readers and statistical analysis were performed for comparisons between the two groups.Results-Mean age of the healthy controls was 11 ± 2.7 years and mean pancreas stiffness was 1.7 ± 0.3 (Reader 1) and 1.7 ± 0.3 (Reader 2) kPa. For patients with ARP or CP, mean age was 12.6 ± 4.4 years and mean pancreas stiffness was 0.9 ± 0.2 (Reader 1) and 1.1 ± 0.3 (Reader 2) kPa. Pancreas stiffness was significantly lower in patients with ARP and CP as compared to healthy controls (p < 0.001). Between readers, there was a strong and statistically significant agreement on measured pancreas stiffness (r = 0.81; p < 0.001). Bland-Altman difference analysis showed a mean bias of only 0.05 kPa (95% limits of agreement: −0.49 to + 0.58) Conclusion-MRE of the pancreas can be performed in pediatric patients. Through this study, we have defined normal pancreas stiffness for children and have shown decreases in measured stiffness in patients with ARP or CP compared to healthy controls.Clinical relevance-3D MRE of the pancreas offers a novel approach for detecting pancreatic disease based on changes in tissue mechanical properties.

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The nutritional status and factors contributing to malnutrition in children with chronic pancreatitis

Cited by 22 publications

References 22 publications

Extracorporeal shock wave lithotripsy is safe and effective for pediatric patients with chronic pancreatitis

Extracorporeal shock wave lithotripsy is safe and effective for pediatric patients with chronic pancreatitis

Nutritional Considerations in Pediatric Pancreatitis

3D MR elastography of the pancreas in children

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