There is limited literature on acute pancreatitis (AP), acute recurrent pancreatitis (ARP), and chronic pancreatitis (CP) in children. The International Study Group of Pediatric Pancreatitis: In Search for a Cure (INSPPIRE) consortium was formed to standardize definitions, develop diagnostic algorithms, investigate disease pathophysiology, and design prospective multicenter studies in pediatric pancreatitis.
Subcommittees were formed to delineate definitions of pancreatitis, and a survey was conducted to analyze present practice.
AP was defined as requiring 2 of the following: abdominal pain compatible with AP, serum amylase and/or lipase values ≥3 times upper limits of normal, and imaging findings of AP. ARP was defined as ≥2 distinct episodes of AP with intervening return to baseline. CP was diagnosed in the presence of typical abdominal pain plus characteristic imaging findings, or exocrine insufficiency plus imaging findings, or endocrine insufficiency plus imaging findings. We found that children with pancreatitis were primarily managed by pediatric gastroenterologists. Unless the etiology was known, initial investigations included serum liver enzymes, triglycerides, calcium, and abdominal ultrasound. Further investigations (usually for ARP and CP) included magnetic resonance or other imaging, sweat chloride, and genetic testing. Respondents’ future goals for INSPPIRE included determining natural history of pancreatitis, developing algorithms to evaluate and manage pancreatitis, and validating diagnostic criteria.
INSPPIRE represents the first initiative to create a multicenter approach to systematically characterize pancreatitis in children. Future aims include creation of patient database and biologic sample repository.
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*Division of Pediatric Gastroenterology and Nutrition, Montreal Children's Hospital, McGill University, Montreal, Canada
†Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Pittsburgh, Pittsburgh, PA
‡Department of Pediatrics, Yale University School of Medicine, New Haven, CT
§Department of Pediatrics, University of Texas Southwestern Medical School, Dallas, TX
||Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA
¶Department of Pediatrics, Hospital for Sick Children, Toronto, Canada
#Department of Medicine, Harvard Medical School, Boston, MA
**Baylor College of Medicine, Houston, TX
††University of Utah, Salt Lake City, UT
‡‡Medical College of Wisconsin, Milwaukee, WI
§§Hadassah University Hospitals, Jerusalem, Israel.
Address correspondence and reprint requests to Dr Aliye Uc, 2865 JPP Pediatrics, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242 (e-mail: email@example.com).
Received 29 December, 2011
Accepted 6 February, 2012
V.D.M. and S.Z.H. participated equally in the present study.
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INSPIRRE members 2010–2011: Maisam Abu-Al-Haija, Rabea Alhosh, Harrison Bai, Bradley Barth, Melena Bellin, Pam Brown, Peter Durie, Douglas Fishman, Steven Freedman, Cheryl Gariepy, Matthew Giefer, Jeff Goldsmith, Tanja Gonska, Julia Greer, Ryan Himes, Sohail Husain, Mel Hyman, Daina Kalnins, Soma Kumar, James Lopez, Mark Lowe, Alan Mayer, Veronique Morinville, Keith Ooi, John Pohl, Alexandra Quittner, Sarah Jane Schwarzenberg, Aliye Uc, James Varni, Narayanan Venkatasubramini, Michael Wilschanski, Steven Werlin. Definitions subcommittee: Veronique D. Morinville (chair), Ryan Himes, John Pohl, Steven Werlin. Survey subcommittee: Sohail Husain (chair); Harrison X. Bai, Bradley Barth, Michael Wilschanski, Rabea Alhosh.
The authors report no conflicts of interest.