Faculty Collaboration Database

Chronic Pancreatitis: Pediatric and Adult Cohorts Show Similarities in Disease Progress Despite Different Risk Factors. J Pediatr Gastroenterol Nutr 2019 Apr;68(4):566-573

Date

03/22/2019

Pubmed ID

30897605

Pubmed Central ID

PMC6492264

DOI

10.1097/MPG.0000000000002279

Scopus ID

2-s2.0-85063613129 (requires institutional sign-in at Scopus site)   60 Citations

Abstract

OBJECTIVES: The aim of the present study was to investigate the natural history of chronic pancreatitis (CP); patients in the North American Pancreatitis Study2 (NAPS2, adults) and INternational Study group of Pediatric Pancreatitis: In search for a cuRE (INSPPIRE, pediatric) were compared.

METHODS: Demographics, risk factors, disease duration, management and outcomes of 224 children and 1063 adults were compared using appropriate statistical tests for categorical and continuous variables.

RESULTS: Alcohol was a risk in 53% of adults and 1% of children (P < 0.0001); tobacco in 50% of adults and 7% of children (P < 0.0001). Obstructive factors were more common in children (29% vs 19% in adults, P = 0.001). Genetic risk factors were found more often in children. Exocrine pancreatic insufficiency was similar (children 26% vs adult 33%, P = 0.107). Diabetes was more common in adults than children (36% vs 4% respectively, P < 0.0001). Median emergency room visits, hospitalizations, and missed days of work/school were similar across the cohorts. As a secondary analysis, NAPS2 subjects with childhood onset (NAPS2-CO) were compared with INSPPIRE subjects. These 2 cohorts were more similar than the total INSPPIRE and NAPS2 cohorts, including for genetic risk factors. The only risk factor significantly more common in the NAPS2-CO cohort compared with the INSPPIRE cohort was alcohol (9% NAPS2-CO vs 1% INSPPIRE cohorts, P = 0.011).

CONCLUSIONS: Despite disparity in age of onset, children and adults with CP exhibit similarity in demographics, CP treatment, and pain. Differences between groups in radiographic findings and diabetes prevalence may be related to differences in risk factors associated with disease and length of time of CP.

Author List

Schwarzenberg SJ, Uc A, Zimmerman B, Wilschanski M, Wilcox CM, Whitcomb DC, Werlin SL, Troendle D, Tang G, Slivka A, Singh VK, Sherman S, Shah U, Sandhu BS, Romagnuolo J, Rhee S, Pohl JF, Perito ER, Ooi CY, Nathan JD, Muniraj T, Morinville VD, McFerron B, Mascarenhas M, Maqbool A, Liu Q, Lin TK, Lewis M, Husain SZ, Himes R, Heyman MB, Guda N, Gonska T, Giefer MJ, Gelrud A, Gariepy CE, Gardner TB, Freedman SD, Forsmark CE, Fishman DS, Cote GA, Conwell D, Brand RE, Bellin M, Barth B, Banks PA, Anderson MA, Amann ST, Alkaade S, Abu-El-Haija M, Abberbock JN, Lowe ME, Yadav D

Author

Steven L. Werlin MD Emeritus Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Alcohol Drinking
Child
Cohort Studies
Cross-Sectional Studies
Demography
Disease Progression
Female
Genetic Predisposition to Disease
Humans
Male
Middle Aged
North America
Pancreatitis, Chronic
Risk Factors
Socioeconomic Factors
Surveys and Questionnaires
Tobacco Smoking