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Characteristics and Frequency of Pediatric Inflammatory Bowel Disease-Associated Pancreatitis: A Japanese Nationwide
Kenji Hosoi1,2, Kei Minowa1, Mitsuyoshi Suzuki1,3
1From the Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan.
Insights
Childhood inflammatory bowel disease (IBD) rarely leads to acute pancreatitis (AP) in Japan, with most cases being mild. Medications used to treat IBD were the primary cause of this association.
Area of Science:
- Gastroenterology
- Pediatric Medicine
- Clinical Research
Background:
- Inflammatory bowel disease (IBD) affects pediatric patients, with a known association with acute pancreatitis (AP).
- Limited data exists on the characteristics and incidence of IBD-associated AP in childhood-onset cases within Japan.
Purpose of the Study:
- To investigate the frequency and clinical features of acute pancreatitis in pediatric patients diagnosed with inflammatory bowel disease in Japan.
Main Methods:
- A nationwide survey was conducted among pediatric IBD patients (<17 years) across 683 Japanese medical centers.
- Data on IBD-associated AP incidence and characteristics were collected through a two-part survey from December 2012 to March 2013.
Main Results:
- The survey included 871 Crohn disease and 1671 ulcerative colitis patients.
- A total of 34 pediatric IBD patients (1.3% Crohn disease, 1.4% ulcerative colitis) developed AP.
- Medication (53%) and primary IBD (32%) were the leading causes of AP, which was consistently mild.
Conclusions:
- Acute pancreatitis is infrequent in pediatric inflammatory bowel disease patients in Japan.
- The majority of IBD-associated AP cases are mild.
- Medications prescribed for IBD treatment are the predominant etiological factor for AP in this population.
Abstract:
Acute pancreatitis (AP) develops in approximately 2% of patients with the diagnosis of inflammatory bowel disease (IBD), but the characteristics and frequency of childhood-onset IBD-associated AP in Japan have not been studied. The present study aimed to clarify the characteristics of IBD-associated AP in Japan.
Methods:
A nationwide survey of pediatric patients with IBD (age, <17 years) was conducted from December 2012 to March 2013 at 683 hospitals and medical centers in Japan. A secondary survey was also sent to the centers with the target patients to evaluate their characteristics.
Results:
The response rate to the first part of the survey was 61.2% (n = 418). In total, 871 patients with Crohn disease and 1671 patients with ulcerative colitis were enrolled. The second part of the survey found that 11 (1.3%) patients with Crohn disease and 23 (1.4%) patients with ulcerative colitis experienced IBD-associated AP caused by medication (n = 18, 53%), a primary disease (n = 11, 32%), autoimmune pancreatitis (n = 1, 3%), or an anatomical abnormality (n = 1, 3%). All the patients had only mild AP.
Conclusions:
IBD-associated AP was not very frequent and was generally mild. The major cause of the pancreatitis was the medication used to treat the IBD.
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