Pancreatitis in children and adolescents

Area of Science:

• Pediatric Gastroenterology
• Clinical Biochemistry

Background:

• Established normal serum amylase levels are crucial for diagnosing pediatric pancreatitis.
• Previous studies may have underestimated normal amylase values in children.

Purpose of the Study:

• To establish normal serum amylase values in the pediatric population.
• To identify common causes, clinical presentations, and outcomes of pancreatitis in children.

Main Methods:

• Serum amylase levels were measured in pediatric patients.
• Retrospective analysis of 54 pediatric pancreatitis cases.
• Correlation analysis between age and serum amylase values.

Main Results:

• Normal pediatric serum amylase: 47.7 +/- 28.6 mg/dl, higher than previously reported.
• Serum amylase positively correlated with age (r = 0.55).
• Top causes: drug-induced (prednisone implicated), idiopathic, traumatic.
• Midepigastric pain and vomiting were common symptoms.
• Elevated amylase (>3x normal) in 63.8%; normal amylase in 17%.
• Mortality: 17.5% for interstitial, 86% for hemorrhagic pancreatitis.

Conclusions:

• Pediatric pancreatitis has distinct etiological and clinical features.
• Normal amylase values in children are higher and increase with age.
• Severe pancreatitis forms have high mortality rates, irrespective of antibiotic/anticholinergic treatment.