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Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0b013e318228574e
Original Articles: Gastroenterology

Novel Characterization of Drug-associated Pancreatitis in Children

Bai, Harrison X.*; Ma, Michael H.*; Orabi, Abrahim I.*; Park, Alexander; Latif, Sahibzada U.; Bhandari, Vineet*; Husain, Sohail Z.*

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Abstract

Background and Objectives: Medications are a major cause of acute pancreatitis; however, little is known about their influence in children. Our primary aims were to identify common comorbidities and concomitant pancreatitis etiologies in children with drug-associated pancreatitis. Our secondary aims were to identify the most commonly associated drugs in the different age groups, evaluate management practices, and compare drug-associated cases with non–drug-associated cases.

Patients and Methods: In the present study, we examined children (ages 0–20 years) admitted to Yale-New Haven Children's Hospital with pancreatitis between 1994 and 2007.

Results: Of a total of 271 pediatric cases, drugs were associated with pancreatitis in 25.6% (55). The 3 most common comorbidities in children with drug-associated pancreatitis were seizure disorders, acute lymphocytic leukemia, and Crohn disease. One third of drug-associated cases had an additional pancreatitis etiology. The most commonly associated drugs were valproic acid and corticosteroids. Compared with non–drug-associated cases, children with drug-associated cases were more likely to undergo CT scanning (54.5% vs 28.4%; P < 0.001), stay in the hospital longer (10 vs 4 days; P < 0.001), and transition to parenteral nutrition from a nil per os status (37.5% vs 21.2%; P < 0.05). There was a higher frequency of valproic acid–associated cases in children younger than 11 years (29.4% vs 9.5% in the 11- to 20-year-old age group).

Conclusions: Our study underscores the importance of considering drugs as a cause and a contributor to pancreatitis in children, particularly valproic acid in young children.

Copyright 2011 by ESPGHAN and NASPGHAN

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