OBJECTIVES: Little is known about risk factors for biliary pancreatitis in children. We characterized cases of pediatric biliary pancreatitis, compared biliary with nonbiliary cases, examined differences in presentation between younger and older children, and studied features distinguishing gallstone- from sludge-induced pancreatitis. METHODS: We evaluated 76 episodes of biliary pancreatitis from 271 cases of acute pancreatitis in children admitted to a tertiary care hospital from 1994 to 2007. RESULTS: Of the 76 cases, 55% had gallstones, 21% had sludge, and 24% had structural defects. Hispanic children had 2.85 (P = 0.01) and 5.59 (P = 0.003) times higher probability for biliary pancreatitis than white and black children, respectively. Median serum amylase and lipase in children with biliary pancreatitis were 64% and 49% higher, respectively, compared with other causes (P < 0.05). In multiple logistic regression, aspartate aminotransferase was an independent predictor of biliary pancreatitis (odds ratio 6.69, P = 0.001). When comparing gallstone- with sludge-induced causes, obesity was an independent predictor (38% more prevalent, P < 0.01) of gallstone cases. CONCLUSIONS: Hispanic ethnicity is a risk factor and aspartate aminotransferase is a biomarker for biliary pancreatitis over other causes. Furthermore, obesity can distinguish gallstone- from sludge-induced pancreatitis. These findings may spur prospective studies to determine the optimal evaluation and management of children with biliary pancreatitis.
OBJECTIVES: Little is known about risk factors for biliary pancreatitis in children. We characterized cases of pediatric biliary pancreatitis, compared biliary with nonbiliary cases, examined differences in presentation between younger and older children, and studied features distinguishing gallstone- from sludge-induced pancreatitis. METHODS: We evaluated 76 episodes of biliary pancreatitis from 271 cases of acute pancreatitis in children admitted to a tertiary care hospital from 1994 to 2007. RESULTS: Of the 76 cases, 55% had gallstones, 21% had sludge, and 24% had structural defects. Hispanic children had 2.85 (P = 0.01) and 5.59 (P = 0.003) times higher probability for biliary pancreatitis than white and black children, respectively. Median serum amylase and lipase in children with biliary pancreatitis were 64% and 49% higher, respectively, compared with other causes (P < 0.05). In multiple logistic regression, aspartate aminotransferase was an independent predictor of biliary pancreatitis (odds ratio 6.69, P = 0.001). When comparing gallstone- with sludge-induced causes, obesity was an independent predictor (38% more prevalent, P < 0.01) of gallstone cases. CONCLUSIONS: Hispanic ethnicity is a risk factor and aspartate aminotransferase is a biomarker for biliary pancreatitis over other causes. Furthermore, obesity can distinguish gallstone- from sludge-induced pancreatitis. These findings may spur prospective studies to determine the optimal evaluation and management of children with biliary pancreatitis.
Authors: A Chak; R H Hawes; G S Cooper; B Hoffman; M F Catalano; R C Wong; T E Herbener; M V Sivak Journal: Gastrointest Endosc Date: 1999-05 Impact factor: 9.427
Authors: Mark D Stringer; Suzanne M Davison; Paddy McClean; Sanjay Rajwal; John W L Puntis; Maria Sheridan; William Ramsden; Helen Woodley Journal: J Pediatr Gastroenterol Nutr Date: 2005-03 Impact factor: 2.839
Authors: J F Miquel; C Covarrubias; L Villaroel; G Mingrone; A V Greco; L Puglielli; P Carvallo; G Marshall; G Del Pino; F Nervi Journal: Gastroenterology Date: 1998-10 Impact factor: 22.682
Authors: Anna C Gay; Nicolas B Barreto; Sheree M Schrager; Christopher J Russell Journal: J Pediatr Gastroenterol Nutr Date: 2018-08 Impact factor: 2.839
Authors: Katherine F Sweeny; Tom K Lin; Jaimie D Nathan; Lee A Denson; Sohail Z Husain; Lindsey Hornung; Tyler Thompson; Maisam Abu-El-Haija Journal: J Pediatr Gastroenterol Nutr Date: 2019-01 Impact factor: 2.839
Authors: Kamaldeen A Muili; Dong Wang; Abrahim I Orabi; Sheharyar Sarwar; Yuhuan Luo; Tanveer A Javed; John F Eisses; Syeda M Mahmood; Shunqian Jin; Vijay P Singh; Meena Ananthanaravanan; George Perides; John A Williams; Jeffery D Molkentin; Sohail Z Husain Journal: J Biol Chem Date: 2012-11-12 Impact factor: 5.157
Authors: Chaitanya Pant; Abhishek Deshpande; Mojtaba Olyaee; Michael P Anderson; Anas Bitar; Marilyn I Steele; Pat F Bass; Thomas J Sferra Journal: PLoS One Date: 2014-05-07 Impact factor: 3.240
Authors: Amy Y Xiao; Marianne L Tan; Maria N Plana; Dhiraj Yadav; Javier Zamora; Maxim S Petrov Journal: Clin Transl Gastroenterol Date: 2018-10-04 Impact factor: 4.488