Maisam Abu-El-Haija1, C Alexander Valencia2, Lindsey Hornung3, Nour Youssef4, Tyler Thompson5, Nathaniel W Barasa6, Xinjian Wang7, Lee A Denson8. 1. Cincinnati Children's Hospital Medical Center, Gastroenterology, Hepatology & Nutrition, 3333 Burnet Ave, Cincinnati, OH, 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. Electronic address: Maisam.Haija@cchmc.org. 2. Cincinnati Children's Hospital Medical Center, USA. Electronic address: alexander.valencia@perkinelmer.com. 3. Cincinnati Children's Hospital Medical Center, Biostatistics and Epidemiology, 3333 Burnet Ave, Cincinnati, OH, 45229, USA. Electronic address: Lindsey.hornung@cchmc.org. 4. Cincinnati Children's Hospital, Clinical Rotation, LAU, School of Medicine, Lebanon. Electronic address: ny31@aub.edu.lb. 5. Cincinnati Children's Hospital Medical Center, Gastroenterology, Hepatology & Nutrition, 3333 Burnet Ave, Cincinnati, OH, 45229, USA. Electronic address: Tyler.Thompson@cchmc.org. 6. Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Laboratory Genetics and Genomics, 3333 Burnet Ave, Cincinnati, OH, 45229, USA. Electronic address: Nathaniel.barasa@cchmc.org. 7. Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Laboratory Genetics and Genomics, 3333 Burnet Ave, Cincinnati, OH, 45229, USA. Electronic address: Xinjian.Wang@cchmc.org. 8. Cincinnati Children's Hospital Medical Center, Gastroenterology, Hepatology & Nutrition, 3333 Burnet Ave, Cincinnati, OH, 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. Electronic address: Lee.denson@cchmc.org.
Abstract
BACKGROUND/ OBJECTIVES: Acute pancreatitis (AP) is emerging in pediatrics. A subset of children with AP progresses to acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP). The role of extensive gene testing in the progression has not been investigated previously. We have followed children enrolled in the registry and at our center for progression to ARP and CP after the first attack. METHODS: This study utilizes an extensive gene sequencing panel as a platform to evaluate the role of genetics in first attack AP, and the progression over time, from first attack to ARP and CP in children. RESULTS: Genes, with corresponding variants were involved in the 3 groups studied: AP, ARP and CP. We have shown that the presence of gene variants from the eight tested genes is enriched in the CP group compared to the AP and ARP groups. The presence of more than one gene was associated with CP (p = 0.01). SPINK1 mutation(s) was significantly associated with faster progression to ARP, (p = 0.04). Having a variant from CFTR, SPINK1 or PRSS1, was associated with the faster progression from AP to CP over time (p < 0.05). CONCLUSIONS: This study shows that genetics have a significant role in progression to ARP and CP from the first attack of pancreatitis.
BACKGROUND/ OBJECTIVES:Acute pancreatitis (AP) is emerging in pediatrics. A subset of children with AP progresses to acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP). The role of extensive gene testing in the progression has not been investigated previously. We have followed children enrolled in the registry and at our center for progression to ARP and CP after the first attack. METHODS: This study utilizes an extensive gene sequencing panel as a platform to evaluate the role of genetics in first attack AP, and the progression over time, from first attack to ARP and CP in children. RESULTS: Genes, with corresponding variants were involved in the 3 groups studied: AP, ARP and CP. We have shown that the presence of gene variants from the eight tested genes is enriched in the CP group compared to the AP and ARP groups. The presence of more than one gene was associated with CP (p = 0.01). SPINK1 mutation(s) was significantly associated with faster progression to ARP, (p = 0.04). Having a variant from CFTR, SPINK1 or PRSS1, was associated with the faster progression from AP to CP over time (p < 0.05). CONCLUSIONS: This study shows that genetics have a significant role in progression to ARP and CP from the first attack of pancreatitis.
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