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Recommendations for Diagnosis and Management of Autoimmune Pancreatitis in Childhood: Consensus From INSPPIRE

Scheers, Isabelle*,†; Palermo, Joseph J.; Freedman, Steven§; Wilschanski, Michael||; Shah, Uzma; Abu-El-Haija, Maisam; Barth, Bradley#; Fishman, Douglas S.**; Gariepy, Cheryl††; Giefer, Matthew J.‡‡; Heyman, Melvin B.§§; Himes, Ryan W.**; Husain, Sohail Z.||||; Lin, Tom K.; Liu, Quin¶¶; Lowe, Mark##; Mascarenhas, Maria***; Morinville, Veronique†††; Ooi, Chee Y.‡‡‡; Perito, Emily R.§§; Piccoli, David A.***; Pohl, John F.§§§; Schwarzenberg, Sarah J.||||||; Troendle, David#; Werlin, Steven¶¶¶; Zimmerman, Bridget###; Uc, Aliye###; Gonska, Tanja*

Journal of Pediatric Gastroenterology and Nutrition: August 2018 - Volume 67 - Issue 2 - p 232–236
doi: 10.1097/MPG.0000000000002028
Clinical Guidelines: Pancreatology

Objectives: Autoimmune pancreatitis (AIP) represents a complex immune-mediated pancreas disorder. Pediatric AIP (P-AIP) is rare. We have recently summarized the characteristic features of P-AIP. We now aim to develop recommendation statements to standardize the diagnostic and therapeutic approach to P-AIP and facilitate future research in the field.

Methods: A panel of pediatric gastroenterologists participating in the International Study Group of Pediatric Pancreatitis: In search for a cuRE was formed to discuss and then vote on 15 recommendation statements. A consensus of at least 80% was obtained following 3 voting rounds and revision of the statements.

Results: We have now generated 15 statements to help standardize the approach to diagnosis and management of P-AIP.

Conclusions: The first P-AIP recommendation statements developed by the International Study Group of Pediatric Pancreatitis: In search for a cuRE group are intended to bring standardization to the diagnosis and treatment of this rare childhood disorder. These statements may help guide a uniform approach to patient care and facilitate future research studies.

*Hospital for Sick Children, Toronto, Ontario, Canada

Cliniques Universitaires St Luc, Brussels, Belgium

Cincinnati Children's Hospital Medical Center, Cincinnati, OH

§Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA

||Hadassah Hebrew University Hospital, Jerusalem, Israel

Harvard Medical School, Massachusetts General Hospital for Children, Boston, MA

#University of Texas Southwestern Medical School, Dallas

**Baylor College of Medicine, Houston, TX

††Nationwide Children's Hospital, Columbus, OH

‡‡Seattle Children's Hospital, Seattle, WA

§§University of California at San Francisco, San Francisco, CA

||||Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA

¶¶Cedars-Sinai Medical Center, Los Angeles, CA

##Washington University School of Medicine, St-Louis, MO

***The Children's Hospital of Philadelphia, Philadelphia, PA

†††Montreal Children's Hospital, McGill University, Montreal, QC, Canada

‡‡‡Discipline of Paediatrics, School of Women's and Children's Health Medicine, University of New South Wales and Sydney Children's Hospital Randwick, Sydney, Australia

§§§University of Utah, Salt Lake City, UT

||||||University of Minnesota, Masonic Children's Hospital, Minneapolis, MN

¶¶¶Medical College of Wisconsin, Milwaukee, WI

###University of Iowa, Carver College of Medicine, Iowa City, IA.

Address correspondence and reprint requests to Tanja Gonska, MD, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1H4 (e-mail:

Received 14 August, 2017

Accepted 18 March, 2018

Aliye Uc and Tanja Gonska are equal senior authors.

This work was supported by NIH DK096327 (A.U.), DK108334 (A.U,); by National Pancreas Foundation (A.U.); INSPPIRE registry was developed by CTSA (2UL1 TR000442) and REDCap.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

M.L. is consultant for AbbVie, Inc; Nordmark Arzneimittel GmbH & Co. KG; is in the Board of Directors of the National Pancreas Association; receives royalties from Millipore Inc. I.S. is supported by a Restracomp Grant and a Fondation St Luc Grant. T.G. received a research grant from Vertex Pharmaceuticals. A.U. is a member of the American Board of Pediatrics, Subboard of Pediatric Gastroenterology. The other authors report no conflicts of interest.

© 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,