Journal article
Risk Factors for Rapid Progression From Acute Recurrent to Chronic Pancreatitis in Children: Report From INSPPIRE
Journal of pediatric gastroenterology and nutrition, Vol.69(2), pp.206-211
08/2019
DOI: 10.1097/MPG.0000000000002405
PMCID: PMC6699635
PMID: 31136562
Abstract
The aim of the study was to determine the rate of progression from acute recurrent pancreatitis (ARP) to chronic pancreatitis (CP) in children and assess risk factors.
Data were collected from the INternational Study group of Pediatric Pancreatitis: In search for a cuRE (INSPPIRE) cohort. Kaplan-Meier curves were constructed to calculate duration of progression from initial attack of acute pancreatitis (AP) to CP. Log-rank test was used to compare survival (nonprogression) probability distribution between groups. Cox proportional hazard regression models were fitted to obtain hazard ratio (with 95% confidence interval [CI]) of progression for each risk variable.
Of 442 children, 251 had ARP and 191 had CP. The median time of progression from initial attack of AP to CP was 3.79 years. The progression was faster in those ages 6 years or older at the first episode of AP compared to those younger than 6 years (median time to CP: 2.91 vs 4.92 years; P = 0.01). Children with pathogenic PRSS1 variants progressed more rapidly to CP compared to children without PRSS1 variants (median time to CP: 2.52 vs 4.48 years; P = 0.003). Within 6 years after the initial AP attack, cumulative proportion with exocrine pancreatic insufficiency was 18.0% (95% CI: 12.4%, 25.6%); diabetes mellitus was 7.7% (95% CI: 4.2%, 14.1%).
Children with ARP rapidly progress to CP, exocrine pancreatic insufficiency, and diabetes. The progression to CP is faster in children who were 6 years or older at the first episode of AP or with pathogenic PRSS1 variants. The factors that affect the aggressive disease course in childhood warrant further investigation.
Details
- Title: Subtitle
- Risk Factors for Rapid Progression From Acute Recurrent to Chronic Pancreatitis in Children: Report From INSPPIRE
- Creators
- Quin Y Liu - Cedars-Sinai Medical Center, Los Angeles, CAMaisam Abu-El-Haija - Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OHSohail Z Husain - Department of Pediatrics, Stanford University, Palo Alto, CABradley Barth - University of Texas Southwestern Medical School, Dallas, TXMelena Bellin - University of Minnesota Masonic Children's Hospital, Minneapolis, MNDouglas S Fishman - Baylor College of Medicine, Houston, TXSteven D Freedman - Harvard Medical School, Boston, MACheryl E Gariepy - Nationwide Children's Hospital, Columbus, OHMatthew J Giefer - Seattle Children's Hospital, Seattle, WATanja Gonska - Hospital for Sick Children, Toronto, ON, CanadaMelvin B Heyman - University of California San Francisco, San Francisco, CARyan Himes - Baylor College of Medicine, Houston, TXTom K Lin - Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OHAsim Maqbool - Children's Hospital of Philadelphia, Philadelphia, PAMaria Mascarenhas - Children's Hospital of Philadelphia, Philadelphia, PABrian A McFerron - Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, INVeronique D Morinville - Montreal Children's Hospital, McGill University, Montreal, QC, CanadaJaimie D Nathan - Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OHChee Y Ooi - School of Women's and Children's Health, Medicine, University of New South Wales and Sydney Children's Hospital Randwick Sydney, AustraliaEmily R Perito - University of California San Francisco, San Francisco, CAJohn F Pohl - University of Utah, Salt Lake City, UTSue Rhee - University of California San Francisco, San Francisco, CASarah J Schwarzenberg - Baylor College of Medicine, Houston, TXUzma Shah - Massachusetts General Hospital for Children, Harvard Medical School, Boston, MADavid Troendle - University of Texas Southwestern Medical School, Dallas, TXSteven L Werlin - Medical College of Wisconsin, Milwaukee, WIMichael Wilschanski - Hadassah Hebrew University Hospital, Jerusalem, IsraelM Bridget Zimmerman - Department of Biostatistics, University of Iowa, Iowa City, IAMark E Lowe - Washington University School of Medicine, St Louis, MOAliye Uc - University of Iowa Stead Family Children's Hospital, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- Journal of pediatric gastroenterology and nutrition, Vol.69(2), pp.206-211
- DOI
- 10.1097/MPG.0000000000002405
- PMID
- 31136562
- PMCID
- PMC6699635
- ISSN
- 0277-2116
- eISSN
- 1536-4801
- Grant note
- R01 DK118752 / NIDDK NIH HHS U01 DK108326 / NIDDK NIH HHS UL1 TR000442 / NCATS NIH HHS U01 DK108334 / NIDDK NIH HHS R21 DK096327 / NIDDK NIH HHS P30 DK054759 / NIDDK NIH HHS
- Language
- English
- Date published
- 08/2019
- Academic Unit
- Stead Family Department of Pediatrics; Biostatistics; Radiation Oncology; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9984214798602771
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