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Pancreatitis in Turkish children: a single center experience

Year 2019, Volume: 44 Issue: 3, 991 - 998, 30.09.2019
https://doi.org/10.17826/cumj.511605

Abstract

Purpose: The aim of this study was to describe the clinical, laboratory and etiologic differences between acute pancreatitis and acute recurrent and chronic pancreatitis in children.

Materials and Methods: We retrospectively evaluated the children with pancreatitis who had been followed between January 2009 and September 2018. Acute recurrent pancreatitis was defined as 2 or more episodes of AP with a return to baseline in the intervals. Chronic pancreatitis was diagnosed in the presence of typical abdominal pain plus characteristic imaging findings or evidence of endocrine or exocrine pancreatic deficiency. The etiologies, demographic features, and laboratory and imaging findings were compared in children with acute pancreatitis (group 1) and acute recurrent and chronic pancreatitis (group 2). 

Results: Twenty-one patients (38.2%) were in acute pancreatitis group (group 1). Group 2 included 27 patients in acute recurrent pancreatitis and 7 patients in chronic pancreatitis [34 patients (61.8%)]. The most common etiologies were idiopathic (61.9%) and drugs (19%) in group 1; idiopathic (47%), hereditary pancreatitis (17.6%), pancreaticobiliary maljunction (14.7%), and congenital anomalies of the pancreatic duct (8.8%) in group 2. There was no statistical difference between the two groups regarding demographic, clinical and laboratory findings except higher gamma-glutamyl transferase in group 2. 

Conclusion: The etiology of pancreatitis in children was mostly idiopathic in two groups in our study. Drugs were the second common cause in acute pancreatitis whereas the other common causes were pancreaticobiliary maljunction and hereditary disorders in acute recurrent pancreatitis or chronic pancreatitis. 


References

  • 1. Lin TK, Troendle DM, Wallihan DB, Barth B, Fox VL, Fishman DS, et al. Specialized Imaging and Procedures in Pediatric Pancreatology: A North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Clinical Report. J Pediatr Gastroenterol Nutr. 2017;64(3):472-484.
  • 2. Petrov MS, Yadav D. Global epidemiology and holistic prevention of pancreatitis. Nat Rev Gastroenterol Hepatol. 2018.
  • 3. Abu-El-Haija M, Lowe ME. Pediatric Pancreatitis-Molecular Mechanisms and Management. Gastroenterol Clin North Am. 2018; 47(4):741-753.
  • 4. Morinville VD, Husain SZ, Bai H, Barth B, Alhosh R, Durie PR, et al. INSPPIRE Group. Definitions of pediatric pancreatitis and survey of present clinical practices. J Pediatr Gastroenterol Nutr. 2012; 55(3):261-5.
  • 5. Poddar U, Yachha SK, Borkar V, Srivastava A, Kumar S. A Report of 320 Cases of Childhood Pancreatitis: Increasing Incidence, Etiologic Categorization, Dynamics, Severity Assessment, and Outcome. Pancreas. 2017; 46(1):110-115.
  • 6. Sweeny KF, Lin TK, Nathan JD, Denson LA, Husain SZ, Hornung L, et al.Rapid Progression of Acute Pancreatitis to Acute Recurrent Pancreatitis in Children. J Pediatr Gastroenterol Nutr. 2019; 68(1):104-109.
  • 7. Taylor CJ, Chen K, Horvath K, Hughes D, Lowe ME, Mehta D, et al. ESPGHAN and NASPGHAN Report on the Assessment of Exocrine Pancreatic Function and Pancreatitis in Children. J Pediatr Gastroenterol Nutr. 2015;61(1):144-53.
  • 8. Premkumar R, Phillips AR, Petrov MS, Windsor JA. The clinical relevance of obesity in acute pancreatitis: targeted systematic reviews. Pancreatology. 2015; 15:25–33.
  • 9. Navina S, Acharya C, DeLany JP, Orlichenko LS, Baty CJ, Shiva SS, et al. Lipotoxicity causes multisystem organ failure and exacerbates acute pancreatitis in obesity. Sci Transl Med. 2011;3:107ra110.
  • 10. Murata A, Ohtani M, Muramatsu K, Kobori S, Tomioka S, Matsuda S. Impact of obesity on outcomes of paediatric acute pancreatitis based on a national administrative database. Pediatr Obes. 2016; 11:174–180.
  • 11. Uc A, Zimmerman MB, Wilschanski M, Werlin SL, Troendle D, Shah U, et al. Impact of Obesity on Pediatric Acute Recurrent and Chronic Pancreatitis. Pancreas. 2018;47(8):967-973.

Türk çocuklarda pankreatit: tek merkez deneyimi

Year 2019, Volume: 44 Issue: 3, 991 - 998, 30.09.2019
https://doi.org/10.17826/cumj.511605

Abstract







Amaç: Bu çalışmada; akut pankreatit, akut tekrarlayan pankreatit ve kronik pankreatit tanısı ile izlenen çocukların klinik, laboratuvar ve etiyolojik farklılıklarının değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntem: Ocak 2009 - Eylül 2018 tarihleri arasında pankreatit tanısı ile izlenen çocuklar geriye dönük olarak değerlendirilmiştir. Akut tekrarlayan pankreatit; ataklar arasında tüm bulguların tamamen normale döndüğü 2 veya daha fazla atak olarak tanımlanmıştır. Kronik pankreatit ise; tipik karın ağrısı ile birlikte görüntülemede karakteristik bulguların varlığı veya ekzokrin veya endokrin pankreas yetmezliği ile birlikte görüntülemede karakteristik bulgular ile koyulmuştur. Akut pankreatit (grup 1) ve akut tekrarlayan ve kronik pankreatit (grup 2) grupları arasında etiyoloji, demografik özellikler, laboratuvar ve radyolojik bulgular karşılaştırılmıştır.

Bulgular: Akut pankreatit grubunda (grup 1)  21 hasta (%38,2) mevcuttur. Grup 2; akut tekrarlayan pankreatit tanısı alan 27 olgu ve kronik pankreatit tanısı ile izlenen 7 olgu içermektedir [toplam 34 olgu (%61,8)] . Pankreatitin sık görülen nedenleri grup 1’de idiyopatik (%61,9) ve ilaçlar (%19); grup 2’de ise idiyopatik (%47), herediter pankreatit (%17,6), pankreatikobiliyer bileşim anomalisi (%14,7) ve pankreatik kanalın konjenital anomalileridir (%8,8). Grup 2’deki gamma-glutamil transferaz yüksekliği dışında, iki grup arasında demografik, klinik ve laboratuvar bulguları açısından istatiksel bir fark bulunmamıştır.

Sonuç: Çalışmamızda tüm gruplarda çoğunlukla pankreatitin nedeni tanımlanamamıştır yani idiyopatiktir. Akut pankreatit olgularında nedenler arasında ikinci sırada ilaçlar yer alırken,  akut tekrarlayan pankreatit ve kronik pankreatitte sık görülen diğer nedenler pankreatikobiliyer bileşim anomalileri ve herediter nedenlerdir. 


References

  • 1. Lin TK, Troendle DM, Wallihan DB, Barth B, Fox VL, Fishman DS, et al. Specialized Imaging and Procedures in Pediatric Pancreatology: A North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Clinical Report. J Pediatr Gastroenterol Nutr. 2017;64(3):472-484.
  • 2. Petrov MS, Yadav D. Global epidemiology and holistic prevention of pancreatitis. Nat Rev Gastroenterol Hepatol. 2018.
  • 3. Abu-El-Haija M, Lowe ME. Pediatric Pancreatitis-Molecular Mechanisms and Management. Gastroenterol Clin North Am. 2018; 47(4):741-753.
  • 4. Morinville VD, Husain SZ, Bai H, Barth B, Alhosh R, Durie PR, et al. INSPPIRE Group. Definitions of pediatric pancreatitis and survey of present clinical practices. J Pediatr Gastroenterol Nutr. 2012; 55(3):261-5.
  • 5. Poddar U, Yachha SK, Borkar V, Srivastava A, Kumar S. A Report of 320 Cases of Childhood Pancreatitis: Increasing Incidence, Etiologic Categorization, Dynamics, Severity Assessment, and Outcome. Pancreas. 2017; 46(1):110-115.
  • 6. Sweeny KF, Lin TK, Nathan JD, Denson LA, Husain SZ, Hornung L, et al.Rapid Progression of Acute Pancreatitis to Acute Recurrent Pancreatitis in Children. J Pediatr Gastroenterol Nutr. 2019; 68(1):104-109.
  • 7. Taylor CJ, Chen K, Horvath K, Hughes D, Lowe ME, Mehta D, et al. ESPGHAN and NASPGHAN Report on the Assessment of Exocrine Pancreatic Function and Pancreatitis in Children. J Pediatr Gastroenterol Nutr. 2015;61(1):144-53.
  • 8. Premkumar R, Phillips AR, Petrov MS, Windsor JA. The clinical relevance of obesity in acute pancreatitis: targeted systematic reviews. Pancreatology. 2015; 15:25–33.
  • 9. Navina S, Acharya C, DeLany JP, Orlichenko LS, Baty CJ, Shiva SS, et al. Lipotoxicity causes multisystem organ failure and exacerbates acute pancreatitis in obesity. Sci Transl Med. 2011;3:107ra110.
  • 10. Murata A, Ohtani M, Muramatsu K, Kobori S, Tomioka S, Matsuda S. Impact of obesity on outcomes of paediatric acute pancreatitis based on a national administrative database. Pediatr Obes. 2016; 11:174–180.
  • 11. Uc A, Zimmerman MB, Wilschanski M, Werlin SL, Troendle D, Shah U, et al. Impact of Obesity on Pediatric Acute Recurrent and Chronic Pancreatitis. Pancreas. 2018;47(8):967-973.
There are 11 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research
Authors

Aysel Ünlüsoy Aksu 0000-0002-4550-0717

Sinan Sarı 0000-0002-6316-4593

Ödül Eğritaş Gürkan 0000-0003-0230-7551

Buket Dalgıç 0000-0003-4678-8764

Publication Date September 30, 2019
Acceptance Date February 16, 2019
Published in Issue Year 2019 Volume: 44 Issue: 3

Cite

MLA Ünlüsoy Aksu, Aysel et al. “Türk çocuklarda Pankreatit: Tek Merkez Deneyimi”. Cukurova Medical Journal, vol. 44, no. 3, 2019, pp. 991-8, doi:10.17826/cumj.511605.