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Incidence and Clinical Associations of Childhood Acute Pancreatitis
Abdalmonem A Majbar1, Eleri Cusick2, Paul Johnson3
1National Institute for Health Research, Bristol Biomedical Research Unit in Nutrition and University of Bristol, United Kingdom; Bristol Royal Hospital for Children, Bristol, United Kingdom; a.a.majbar@bristol.ac.uk.
Insights
Childhood acute pancreatitis (AP) is uncommon in the UK, with over one case diagnosed weekly. Pakistani children show a significantly higher incidence, warranting further research into this disparity.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Public Health
Background:
- Acute pancreatitis (AP) in children is a rare but serious condition.
- Understanding the incidence and associations of childhood AP is crucial for effective management and prevention.
Purpose of the Study:
- To determine the incidence of acute pancreatitis (AP) in children aged 0 to 14 years in the United Kingdom.
- To identify the clinical associations and risk factors for childhood AP in the UK.
Main Methods:
- A nationwide surveillance study was conducted using the British Pediatric Surveillance Unit from April 2013 to April 2014.
- Data collection involved monthly reporting of new AP cases in children under 15, with a 1-year administrative follow-up.
Main Results:
- The UK incidence of childhood AP was 0.78 per 100,000 children/year.
- Pakistani children had a sevenfold higher incidence (4.55 per 100,000) compared to white children (0.63 per 100,000).
- Idiopathic AP accounted for 37% of cases, followed by drug therapy (19%) and gallstones (13%).
Conclusions:
- Childhood AP is diagnosed weekly in the UK, highlighting its continued relevance.
- Significant shifts in AP associations have occurred since the 1970s-80s.
- The overrepresentation of Pakistani children with AP requires further investigation.
Objectives:
To establish the UK incidence and clinical associations of acute pancreatitis (AP) in children aged 0 to 14 years.
Methods:
Monthly surveillance of new cases of AP in children under 15 years of age through the British Pediatric Surveillance Unit conducted from April 2013 to April 2014 (inclusive) followed by 1-year administrative follow-up for all valid cases.
Results:
Ninety-four cases (48 boys) fulfilled the diagnostic criteria. The median age at diagnosis was 11.2 years (range 1.3-14.9). White children accounted for 61% of the cases compared with 28% from Asian and 5% from African ethnicities. Pakistani children accounted for 18 of 26 (69%) Asian patients and 19% of the total cohort. The incidence of AP in children in the United Kingdom was 0.78 per 100 000/year (95% confidence interval [CI] 0.62-0.96). The incidence in Pakistani children (4.55; 95% CI 2.60-7.39) was sevenfold greater than white children (0.63; 95% CI 0.47-0.83). Of the 94 cases, 35 (37%) were idiopathic; other associations were: drug therapy, 18 (19%); gallstones, 12 (13%); hereditary, 7 (7%); organic acidemias, 7 (7%); anatomic anomalies, 5 (5%); viral infections, 3 (3%); systemic diseases, 2 (2%); and trauma 1 (1%). The most common drug associations were asparaginase (28%), azathioprine (17%), and sodium valproate (17%).
Conclusions:
Although still relatively uncommon in the United Kingdom, on average there is >1 case of childhood AP diagnosed every week. The associations of AP have changed significantly since the 1970-80s. Overrepresentation of Pakistani children is worthy of further investigation.
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