Pancreatic Disorders in Children with Inflammatory Bowel Disease
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Studies on Acute Pancreatitis (AP)
3.2. Studies on Chronic Pancreatitis (CP)
3.3. Studies Related to Asymptomatic Pancreatic Hyperenzynemia
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Authors, Year of the Publication | Pancreatic Disorder | Number of Affected Children with IBD | Etiology of Pancreatic Disease | Severity of Pancreatic Disease | Comments Analyzed Population; Mean Age (Ranges) at the Time of Pancreatic Involvement | ||
---|---|---|---|---|---|---|---|
CD n (%) | UC n (%) | IBD-U | |||||
Martinelli et al., 2015 [8] | AP HA/HL | 6/284 (2%) 7/284 (2%) | 4/290 (1.4%) 8/290 (2.8%) | 1/48 (2%) 1/48 (2%) | No data | Mild | IBD with pancreatic involvement; age 12.3 (5.4–25.9); active IBD in 85.1% of both AP and HA/HL group; in 18.5% of cases pancreatic involvement at the time of IBD diagnosis |
Weber et al., 1993 [9] | AP | 1/12 (8.3%) 1/12 (8.3%) | NA | NA | Sulfasalazine Pancreas divisum | No data | CD; age of study group: 10–50 yr; only two children (10 yr and 18 yr) in the study group; 10-yr-old boy developed AP induced by sulfasalazine at the time of CD diagnosis, symptoms resolved after drug discontinuation 18-yr-old girl developed AP one year after CD, AP due to pancreas divisum |
Broide et al., 2011 [10] | AP | 6/460 (1.3%) | 4/460 (0.9%) | No data | Idiopathic | Mild | AP preceded the IBD diagnosis in 12/460 patients including two adults; mean age of children was 13 ± 4.8 (range 3–19) yr, the description of the study group includes adults; nine patients had moderate to severe IBD |
Wintzell et al., 2019 [11] | AP | 21/1923 (1.1%) | 19/1451 (1.3%) | No data | AZA | No data | IBD treated with AZA; age at the time of pancreatic involvement—no data; similar rate of AP in boys and girls and UC and CD |
Dubinsky et al., 2000 [12] | AP HA/HL | 1/92 (1%) children with IBD6/92 (6.5%) children with IBD | AZA/6MP | No data | IBD treated with AZA/6MP; age at the time of pancreatic involvement—no data; IBD type - no data; normal TMPT genotype, no correlation between 6-MP dose or metabolite levels and pancreatic toxicity | ||
Hindorf et al., 2006 [13] | AP | 2/79 (2.5%) children with IBD | No data | AZA | No data | IBD treated with AZA; age of the study group: 17–51 yr; age at the time of pancreatic involvement—no data; there was no difference in TPMT activity between patients with pancreatitis and patients without adverse event | |
De Ridder et al., 2006 [14] | AP | 4/72 (5.6%) children with IBD | No data | AZA | No data | IBD treated with AZA; age at the time of pancreatic involvement—no data; IBD type not specified; normal TMPT genotype | |
Tajiri et al., 2008 [15] | AP | NA | 1/35 | No data | AZA/6MP | No data | UC treated with AZA/6MP; age at the time of pancreatic involvement—no data. |
Cuffari et al., 1996 [16] | AP | 4/15 (16%) | NA | No data | 6MP | No data | CD treated with 6MP; age at the time of pancreatic involvement—no data |
Kirschner et al., 1998 [17] | AP | 2/95 (2%) | 2/95 (2%) | 0/95 | AZA/6MP | No data | IBD treated with AZA/6MP; age 11.5–16.2 yr; drug discontinued |
Keljo et al., 1997 [18] | AP AP AP AP | 1/10 2/10 2/10 2/10 | 0/10 0/10 1/10 2/10 | No data | 5-ASA AZA Biliary pancreatitis Idiopathic | No data No data No data Mild | 8.6-yr-old girl, AP symptoms resolved after 5-ASA discontinuation 17.9-yr-old girl; 12.3-yr-old girl; in both cases symptoms resolved 17.2-yr-old girl with CD; 13.7-yr-old girl with CD; 12.8-yr-old girl with UC 12.7-yr-old boy and 10.8-yr-old girl with CD; 9.9-yr-old and 14.9-yr-old girls with UC. |
Bai et al., 2011 [19] | AP | 6/51 (10.9%) | 5/51 (9.1%) | No data | Drug | No data | Drug-induced pancreatitis; no demographic data on patients with CD and UC |
Scheers et al., 2017 [20] | AIP | 1/16 (6.3%) | 3/16 (18.8%) | No data | AIP | No data | AIP; no demographic data on patients with CD and UC |
Jose et.al., 2009 [1] | Pancreatitis | 37/387 (9.6%) children with IBD | No data | No data | No data | IBD and EIMs; age at the time of pancreatic involvement—no data; IBD type not specified, pancreatitis type not specified | |
Dotson et al., 2010 [2] | Pancreatitis | 5/728 (0.7%) | 4/281 (1.4%) | No data | No data | No data | IBD and EIMs; age at the time of pancreatic involvement—no data; pancreatitis type not specified |
Ghersin et al., 2020 [21] | Pancreatitis | 5/231 (0.8%) | 3/231 (1%) | No data | No data | No data | Jewish adolescents with IBD; age at the time of pancreatic involvement—no data; IBD type—no data, pancreatitis type—no data |
Authors, Year of the Publication | Pancreatic Disorder; AP Severity | Etiology of Pancreatic Disease | CD n (%) | UC n (%) | Comment |
---|---|---|---|---|---|
Gallego-Gutierrez et al., 2015 [22] | AP; mild, moderate | AZA | 2 cases (10- and 13-yr-old) | NA | AP symptoms resolved after AZA discontinuation; normal TMPT genotype |
Yi et al., 2012 [23] | AP; severity-no data | AZA/6MP | 1 case (14-yr-old) | NA | AP symptoms resolved after AZA/6MP discontinuation |
Ledder et al., 2013 [24] | AP; mild | AZA | 4 cases (11-, 13-, 13-, 14-yr-old) | NA | AP symptoms resolved after AZA discontinuation; 6MP was successfully used |
Mishra et al., 2020 [25] | AP; mild | AZA | 1 case (16-yr-old) | NA | AP symptoms resolved after AZA discontinuation; normal TMPT genotype |
Abdullah et al., 1993 [26] | AP; severity-no data | ASA | NA | 1 case (12-yr-old) | Sulfasalazine/mesalamine-induced AP; AP symptoms resolved after drug discontinuation |
Paul et al., 2000 [27] | AP; severity-no data | ASA | NA | 1 case (10-yr-old) | AP symptoms resolved after drug discontinuation |
Radke et al., 1993 [28] | AP; moderate | ASA | 1 case (12-yr-old) | NA | AP symptoms resolved after drug discontinuation |
Garau et al., 1994 [29] | AP; severity-no data | ASA | NA | 3 cases (12, 12 and 13-yr-old) | AP symptoms resolved after drug discontinuation in all cases, but in one case intractable severe colitis unresponsive to intensive therapy led to subtotal colectomy |
Paerregaard et al., 1997 [30] | AP; severity-no data | ASA | NA | 1 case (7-yr-old) | AP induced by oral or rectal administration of 5-ASA; AP symptoms resolved after drug discontinuation |
Chung et al., 2015 [31] | AP; severity-no data | ASA | NA | 1 case (11-yr-old) | AP coexisting with pneumonitis induced by mesalazine; AP symptoms resolved after drug discontinuation |
Lopez et al., 2018 [32] | AP; severity-no data | Vedolizumab | NA | 1 case (14-yr-old) | AP symptoms resolved after drug discontinuation, but refractory colitis led to subtotal colectomy |
Noseworthy et al., 1983 [33] | AP, severe | Intralipid-supplemented TPN | 2 cases with IBD (not specified type of IBD) | AP developed after 7 weeks of 20% Intralipid-supplemented TPN combined with high dose of steroid | |
Lashner et al., 1986 [34] | AP, mild | Intralipid-supplemented TPN | 1 case (17-yr-old) | NA | AP developed after 6 weeks of 20% Intralipid-supplemented TPN combined with steroid and oral foods (small amount) |
Gouveia et al., 2018 [35] | AP; severity-no data | AIP | NA | 1 case (13-yr-old) | AIP preceded UC diagnosis; AIP therapy with an endoscopic retrograde cholangiopancreatography (ERCP) with stent placement induced sustain AIP remission |
Cousin et al., 2018 [36] | AP; severe | AIP type 2 | NA | 1 case (16-yr-old) | AP with elevated IgG4, cholestasis with cirrhosis and UC |
Kolasinski et al., 2017 [37] | AP; severity-no data | AIP type 2 | NA | 1 case (15-yr-old) | AIP with elevated IgG4 and coexisted with UC with no intestinal complaints |
Dogan et al., 2020 [38] | AP; severity-no data | AIP | 1 case (16-yr-old) | NA | AIP with elevated IgG4 preceded CD diagnosis |
Kugathasan at al., 2002 [39] | AP; severity-no data | Idiopathic | 3 cases (12, 13 and 16-yr-old) | NA | AP preceded CD development |
Endo et al., 2021 [40] | AP; severity-no data | Idiopathic | 1 case (16-yr-old) | NA | AP preceded CD diagnosis |
Watanabe 2008 [41] | AP, mild | idiopathic | NA | 1 case (15-yr-old) | AP coexisted with parotitis |
Knafelz et al., 2013 [42] | CP | CFTR mutation | 1 case (4-yr-old) | NA | CP preceded CD development |
Evans et al., 1996 [43] | CP | Biliary tract obstruction | 1 case (13-yr-old) | NA | CP with biliary tract obstruction preceded CD development |
Potamianos et al., 2000 [44] | CP | Idiopathic | 1 case (16-yr-old) | NA | Fibrosing pancreatitis preceded CD development |
Silbermintz et al., 2006 [45] | Pancreatitis | Idiopathic | 1 case (10-yr-old) | NA | Coexistence of CD, granulomatous pneumonitis, and PCS |
Kim et al., 2019 [46] | AP; severity-no data | Indigo-naturalis | 1 case (11-yr-old) | NA | Boy with severe CD |
Briem-Richter et al., 2010 [47] | AP; severity-no data | Hemorrhagic necrotizing pancreatitis | 1 case (6-yr-old) | NA | CD and familial hyperparathyreoidism |
Venkataraman et al., 2012 [48] | HA | Idiopathic | 1 case (13-yr-old) | NA | CD and macroamylasemia |
Ray et al., 2016 [49] | HL | Idiopathic | NA | 1 case (13-yr-old) | HL correlated with severity of UC and lipase activity decreased when remission of UC was achieved |
Drug | Potential Mechanism of Pancreatitis |
---|---|
5-ASA | Hypersensitivity reaction [46] Increased pancreatic duct permeability [61] |
AZA | Direct toxic reaction [62] Genetic predisposition [63] Immunological reaction [24,64] Idiosyncratic reaction [24,65,66] Conflicting data: inosine triphosphate pyrophosphatase (ITPase) deficiency [14,67] |
6-MP | Direct toxic reaction [62] Genetic predisposition [63] |
Vedolizumab | Dysregulation of immune response [32] |
Intralipid-supplemented total parental nutrition (TPN) | Hyperlipidemia in combination with high dose of steroid [33] |
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Jakimiec, P.; Zdanowicz, K.; Kwiatek-Sredzinska, K.; Filimoniuk, A.; Lebensztejn, D.; Daniluk, U. Pancreatic Disorders in Children with Inflammatory Bowel Disease. Medicina 2021, 57, 473. https://doi.org/10.3390/medicina57050473
Jakimiec P, Zdanowicz K, Kwiatek-Sredzinska K, Filimoniuk A, Lebensztejn D, Daniluk U. Pancreatic Disorders in Children with Inflammatory Bowel Disease. Medicina. 2021; 57(5):473. https://doi.org/10.3390/medicina57050473
Chicago/Turabian StyleJakimiec, Piotr, Katarzyna Zdanowicz, Kamila Kwiatek-Sredzinska, Aleksandra Filimoniuk, Dariusz Lebensztejn, and Urszula Daniluk. 2021. "Pancreatic Disorders in Children with Inflammatory Bowel Disease" Medicina 57, no. 5: 473. https://doi.org/10.3390/medicina57050473
APA StyleJakimiec, P., Zdanowicz, K., Kwiatek-Sredzinska, K., Filimoniuk, A., Lebensztejn, D., & Daniluk, U. (2021). Pancreatic Disorders in Children with Inflammatory Bowel Disease. Medicina, 57(5), 473. https://doi.org/10.3390/medicina57050473