Burcu VOLKAN, Ali İSLEK, Dilara Fatma Kocacik UYGUN, Erkan PARLAK

Delayed diagnosis of chronic pancreatitis with Cystic Fibrosis and Pancreas Divisium

The incidence of pancreatitis in children and adolescents has increased in recent years. The etiology of pancreatitis is more diverse in children compared to adults. Pancreatitis may present as acute pancreatitis, recurrent acute pancreatitis or chronic relapsing pancreatitis. The majority of children with chronic pancreatitis had identifiable genetic risk factors associated with pancreatitis or congenital anomalies of the pancreaticobiliary system. Pancreatitis is a known complication of cystic fibrosis (CF) and may be the first manifestation of the disease in some cases. We report a case of late-diagnosed CF presenting with chronic pancreatitis and pancreas divisum

PDF

___

1. Bai HX, Lowe ME, Husain SZ. What have we learned about acute pancreatitis in children? J Pediatr Gastroenterol Nutr. 2011;52(3):262-70.

2. Nydegger A, Couper RT, Oliver MR. Childhood pancreatitis. J Gastroenterol Hepatol. 2006;21(3):499-509.

3. Schwarzenberg SJ, Bellin M, Husain SZ, at all. Pediatric chronic pancreatitis is associated with genetic risk factors and substantial disease burden. J Pediatr. 2015;166(4):890-6.

4. Werlin SL, Kugathasan S, Frautschy BC. Pancreatitis in children. J Pediatr Gastroenterol Nutr. 2003;37(5):591-5.

5. Poddar U, Yachha SK, Mathias A, Choudhuri G. Genetic predisposition and its impact on natural history of idiopathic acute and acute recurrent pancreatitis in children. Dig Liver Dis. 2015;47(8):709-14.

6. WD Jackson. Pancreatitis: etiology, diagnosis, and management. Current opinion in pediatrics. 2001;13(5):447-51.

7. Bertin C, Pelletier AL, Vullierme MP, Bienvenu T, Rebours V, Hentic O, Maire F, Hammel P, Vilgrain V, Ruszniewski P, Lévy P. Pancreas divisum is not a cause of pancreatitis by itself but acts as a partner of genetic mutations. Am J Gastroenterol. 2012;107(2):311-7.

8. Nydegger A, Heine RG, Ranuh R, Gegati-Levy R, Crameri J, Oliver MR. Changing incidence of acute pancreatitis: 10- year experience at the Royal Children's Hospital, Melbourne. J Gastroenterol Hepatol. 2007;22(8):1313-6.

9. Lopez MJ. The changing incidence of acute pancreatitis in children: a single-institution perspective. J. Pediatr. 2002;140(5):622-4.

10. Lucidi V, Alghisi F, Dall'Oglio L, D'Apice MR, Monti L, De Angelis P, Gambardella S, Angioni A, Novelli G. The etiology of acute recurrent pancreatitis in children: a challenge for pediatricians. Pancreas. 2011;40(4):517-21.

11. Keim V. Role of genetic disorders in acute recurrent pancreatitis. World J Gastroenterol. 2008;14(7):1011–5.

12. Messick J. A 21st-century approach to cystic fibrosis: optimizing outcomes across the disease spectrum. J Pediatr Gastroenterol Nutr. 2010;51(7):1-7.

13. Ko SB, Azuma S, Yoshikawa T, Yamamoto A, Kyokane K, Ko MS, Ishiguro H. Molecular mechanisms of pancreatic stone formation in chronic pancreatitis. Front Physiol. 2012;3:415.