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Natural history of pancreatic involvement in paediatric inflammatory bowel disease
Massimo Martinelli1, Caterina Strisciuglio1, Maria Teresa Illiceto2
1Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy.
Insights
Pancreatic involvement, including acute pancreatitis, affects over 4% of pediatric inflammatory bowel disease patients. Monitoring pancreatic function is crucial as damage can progress over time.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Pancreatic Disease
Background:
- Limited case reports exist on pancreatic involvement in pediatric inflammatory bowel disease (IBD).
- Understanding the clinical features and disease course of pancreatic complications in IBD is essential.
Purpose of the Study:
- To determine the prevalence of pancreatitis and persistent pancreatic enzyme elevations in children with IBD.
- To investigate the disease course of pancreatic involvement in pediatric IBD patients.
Main Methods:
- Retrospective analysis of a web-registry of pediatric IBD patients.
- Identification of patients with hyperamylasemia and hyperlipasemia.
- Follow-up evaluations at 6 months and 1 year.
Main Results:
- 4.1% of pediatric IBD patients exhibited hyperamylasemia and hyperlipasemia; 1.6% met criteria for acute pancreatitis.
- Female gender and colonic disease were associated with acute pancreatitis.
- Pancreatic involvement showed varied progression, with some cases resolving and others persisting or evolving to chronic pancreatitis.
Conclusions:
- Acute pancreatitis in pediatric IBD is more frequent in cases with colonic disease and in females.
- Regular monitoring of pancreatic function is recommended in children with IBD due to the potential for evolving pancreatic damage.
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.
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