Journal article
Toxic-metabolic Risk Factors in Pediatric Pancreatitis: Recommendations for Diagnosis, Management, and Future Research
Journal of pediatric gastroenterology and nutrition, Vol.62(4), pp.609-617
04/2016
DOI: 10.1097/MPG.0000000000001035
PMCID: PMC4805437
PMID: 26594832
Abstract
Pancreatitis in children can result from metabolic and toxic risk factors, but the evidence linking these factors is sparse. We review the evidence for association or causality of these risk factors in pancreatitis, discuss management strategies, and their rationale. We conducted a review of the pediatric pancreatitis literature with respect to the following risk factorshyperlipidemia, hypercalcemia, chronic renal failure, smoking exposure, alcohol, and medications. Areas of additional research were identified. Hypertriglyceridemia of 1000 mg/dL or greater poses an absolute risk for pancreatitis; persistent elevations of calcium are predisposing. Further research is necessary to determine whether end-stage renal disease leads to increased pancreatitis in children similar to adults. It is unknown whether cigarette smoking exposure, which clearly increases risk in adults, also increases risk in children. The role of alcohol in pediatric pancreatitis, whether direct or modifying, needs to be elucidated. The evidence supporting most cases of medication-induced pancreatitis is poor. Drug structure, improper handling of drug by host, and bystander status may be implicated. Other pancreatitis risk factors must be sought in all cases. The quality of evidence supporting causative role of various toxic and metabolic factors in pediatric pancreatitis is variable. Careful phenotyping is essential, including search for other etiologic risk factors. Directed therapy includes correction/removal of any agent identified, and general supportive measures. Further research is necessary to improve our understanding of these pancreatitis risk factors in children.
Details
- Title: Subtitle
- Toxic-metabolic Risk Factors in Pediatric Pancreatitis: Recommendations for Diagnosis, Management, and Future Research
- Creators
- Sohail Husain - Childrenʼs Hospital of Pittsburgh, Pittsburgh, PA †Montreal Childrenʼs Hospital, McGill University, Montreal, QC, Canada ‡University of Utah, Salt Lake City §Cincinnati Childrenʼs Hospital Medical Center, Cincinnati, OH ||University of Minnesota Masonic Childrenʼs Hospital, Minneapolis ¶Harvard Medical School, Boston, MA #First Department of Medicine, University of Szeged and HAS-SZTE Monument Gastroenterology Multidisciplinary Research Group, Szeged, Hungary University of California at San Francisco, San Francisco ††Baylor College of Medicine, Houston, TX ‡‡Discipline of Paediatrics, School of Womenʼs and Childrenʼs Health, Medicine, University of New South Wales and Sydney Childrenʼs Hospital Randwick, Sydney, Australia §§University of Iowa Carver College of Medicine, Iowa CityVeronique MorinvilleJohn PohlMaisam Abu-El-HaijaMelena BellinSteve FreedmanPeter HegyiMelvin HeymanRyan HimesChee OoiSarah SchwarzenbergDanielle UsatinAliye Uc
- Resource Type
- Journal article
- Publication Details
- Journal of pediatric gastroenterology and nutrition, Vol.62(4), pp.609-617
- DOI
- 10.1097/MPG.0000000000001035
- PMID
- 26594832
- PMCID
- PMC4805437
- NLM abbreviation
- J Pediatr Gastroenterol Nutr
- ISSN
- 0277-2116
- eISSN
- 1536-4801
- Publisher
- by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology
- Grant note
- DOI: 10.13039/100000062, name: National Institute of Diabetes and Digestive and Kidney Diseases
- Language
- English
- Date published
- 04/2016
- Academic Unit
- Stead Family Department of Pediatrics; Radiation Oncology; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9984047725102771
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