TY - JOUR
T1 - Definitions of pediatric pancreatitis and survey of present clinical practices
AU - Morinville, Veronique D.
AU - Husain, Sohail Z.
AU - Bai, Harrison
AU - Barth, Bradley
AU - Alhosh, Rabea
AU - Durie, Peter R.
AU - Freedman, Steven D.
AU - Himes, Ryan
AU - Lowe, Mark E.
AU - Pohl, John
AU - Werlin, Steven
AU - Wilschanski, Michael
AU - Uc, Aliye
PY - 2012/9
Y1 - 2012/9
N2 - Objectives: There is limited literature on acute pancreatitis (AP), acute recurrent pancreatitis (ARP), and chronic pancreatitis (CP) in children. The International Study Group of Pediatric Pancreatitis: In Search for a Cure (INSPPIRE) consortium was formed to standardize definitions, develop diagnostic algorithms, investigate disease pathophysiology, and design prospective multicenter studies in pediatric pancreatitis. Methods: Subcommittees were formed to delineate definitions of pancreatitis, and a survey was conducted to analyze present practice. Results: AP was defined as requiring 2 of the following: abdominal pain compatible with AP, serum amylase and/or lipase values 3 times upper limits of normal, and imaging findings of AP. ARP was defined as 2 distinct episodes of AP with intervening return to baseline. CP was diagnosed in the presence of typical abdominal pain plus characteristic imaging findings, or exocrine insufficiency plus imaging findings, or endocrine insufficiency plus imaging findings. We found that children with pancreatitis were primarily managed by pediatric gastroenterologists. Unless the etiology was known, initial investigations included serum liver enzymes, triglycerides, calcium, and abdominal ultrasound. Further investigations (usually for ARP and CP) included magnetic resonance or other imaging, sweat chloride, and genetic testing. Respondents' future goals for INSPPIRE included determining natural history of pancreatitis, developing algorithms to evaluate and manage pancreatitis, and validating diagnostic criteria. Conclusions: INSPPIRE represents the first initiative to create a multicenter approach to systematically characterize pancreatitis in children. Future aims include creation of patient database and biologic sample repository.
AB - Objectives: There is limited literature on acute pancreatitis (AP), acute recurrent pancreatitis (ARP), and chronic pancreatitis (CP) in children. The International Study Group of Pediatric Pancreatitis: In Search for a Cure (INSPPIRE) consortium was formed to standardize definitions, develop diagnostic algorithms, investigate disease pathophysiology, and design prospective multicenter studies in pediatric pancreatitis. Methods: Subcommittees were formed to delineate definitions of pancreatitis, and a survey was conducted to analyze present practice. Results: AP was defined as requiring 2 of the following: abdominal pain compatible with AP, serum amylase and/or lipase values 3 times upper limits of normal, and imaging findings of AP. ARP was defined as 2 distinct episodes of AP with intervening return to baseline. CP was diagnosed in the presence of typical abdominal pain plus characteristic imaging findings, or exocrine insufficiency plus imaging findings, or endocrine insufficiency plus imaging findings. We found that children with pancreatitis were primarily managed by pediatric gastroenterologists. Unless the etiology was known, initial investigations included serum liver enzymes, triglycerides, calcium, and abdominal ultrasound. Further investigations (usually for ARP and CP) included magnetic resonance or other imaging, sweat chloride, and genetic testing. Respondents' future goals for INSPPIRE included determining natural history of pancreatitis, developing algorithms to evaluate and manage pancreatitis, and validating diagnostic criteria. Conclusions: INSPPIRE represents the first initiative to create a multicenter approach to systematically characterize pancreatitis in children. Future aims include creation of patient database and biologic sample repository.
KW - acute pancreatitis
KW - acute recurrent pancreatitis
KW - chronic pancreatitis
KW - definitions
KW - pediatrics
KW - practice parameters
UR - http://www.scopus.com/inward/record.url?scp=84865722339&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84865722339&partnerID=8YFLogxK
U2 - 10.1097/MPG.0b013e31824f1516
DO - 10.1097/MPG.0b013e31824f1516
M3 - Article
C2 - 22357117
AN - SCOPUS:84865722339
SN - 0277-2116
VL - 55
SP - 261
EP - 265
JO - Journal of pediatric gastroenterology and nutrition
JF - Journal of pediatric gastroenterology and nutrition
IS - 3
ER -