Massimo Martinelli1, Caterina Strisciuglio1, Maria Teresa Illiceto2, Sabrina Cardile3, Graziella Guariso4, Silvia Vignola5, Marina Aloi6, Mario Rocco D'Altilia7, Patrizia Alvisi8, Silvia Salvatore9, Annamaria Staiano1, Salvatore Cucchiara6, Erasmo Miele10. 1. Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy. 2. Pediatric Gastroenterology Unit, Spirito Santo Hospital, Pescara, Italy. 3. Endoscopy and Gastroenterology Unit, Department of Pediatrics, University of Messina, Italy. 4. Department of Pediatrics, Unit of Gastroenterology, University Hospital of Padova, Italy. 5. Gastroenterology and Endoscopy Unit, G. Gaslini Institute for Children, Genoa, Italy. 6. Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Italy. 7. Division of Pediatrics, General Hospital I.R.C.C.S., S. G. Rotondo (Fg), Italy. 8. Pediatric Unit, Maggiore Hospital, Bologna, Italy. 9. Department of Pediatrics, University of Insubria, Varese, Italy. 10. Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy. Electronic address: erasmo.miele@unina.it.
Abstract
BACKGROUND: Few case reports describe the clinical features of pancreatic involvement in inflammatory bowel disease. AIM: To investigate prevalence and disease course of inflammatory bowel disease children with pancreatitis and with exclusive hyperamylasemia and hyperlipasemia. METHODS: We used a web-registry to retrospectively identify paediatric inflammatory bowel disease patients with hyperamylasemia and hyperlipasemia. Participants were re-evaluated at 6 months and 1 year. RESULTS: From a total of 649 paediatric patients, we found 27 with hyperamylasemia and hyperlipasemia (4.1%). Eleven patients (1.6%) fulfilled diagnostic criteria for acute pancreatitis. Female gender was significantly associated with acute pancreatitis (p=0.04). Twenty-five children (92.5%) had colonic disease. At 6 months 1/11 children with acute pancreatitis (9%) showed acute recurrent pancreatitis, while 1 patient (9%) had persistent hyperamylasemia and hyperlipasemia. At 12 months, 1 patient showed chronic pancreatitis (9.1%). Of the 16 children with exclusive hyperamylasemia and hyperlipasemia, 4 developed acute pancreatitis (25%), while 1 patient (6.2%) still presented exclusive hyperamylasemia and hyperlipasemia at 6 months. At 12 months, 11/16 patients (68.7%) reached a remission of pancreatic involvement, whereas 5 remaining patients (32.3%) had persistent hyperamylasemia and hyperlipasemia. CONCLUSIONS: In inflammatory bowel disease children, acute pancreatitis is more common in colonic disease and in female gender. Pancreatic function should be monitored, considering that pancreatic damage may evolve.
BACKGROUND: Few case reports describe the clinical features of pancreatic involvement in inflammatory bowel disease. AIM: To investigate prevalence and disease course of inflammatory bowel diseasechildren with pancreatitis and with exclusive hyperamylasemia and hyperlipasemia. METHODS: We used a web-registry to retrospectively identify paediatric inflammatory bowel diseasepatients with hyperamylasemia and hyperlipasemia. Participants were re-evaluated at 6 months and 1 year. RESULTS: From a total of 649 paediatric patients, we found 27 with hyperamylasemia and hyperlipasemia (4.1%). Eleven patients (1.6%) fulfilled diagnostic criteria for acute pancreatitis. Female gender was significantly associated with acute pancreatitis (p=0.04). Twenty-five children (92.5%) had colonic disease. At 6 months 1/11 children with acute pancreatitis (9%) showed acute recurrent pancreatitis, while 1 patient (9%) had persistent hyperamylasemia and hyperlipasemia. At 12 months, 1 patient showed chronic pancreatitis (9.1%). Of the 16 children with exclusive hyperamylasemia and hyperlipasemia, 4 developed acute pancreatitis (25%), while 1 patient (6.2%) still presented exclusive hyperamylasemia and hyperlipasemia at 6 months. At 12 months, 11/16 patients (68.7%) reached a remission of pancreatic involvement, whereas 5 remaining patients (32.3%) had persistent hyperamylasemia and hyperlipasemia. CONCLUSIONS: In inflammatory bowel diseasechildren, acute pancreatitis is more common in colonic disease and in female gender. Pancreatic function should be monitored, considering that pancreatic damage may evolve.
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