TY - JOUR
T1 - Causal evaluation of acute recurrent and chronic pancreatitis in children
T2 - Consensus from the INSPPIRE group
AU - Gariepy, Cheryl E.
AU - Heyman, Melvin B.
AU - Lowe, Mark E.
AU - Pohl, John F.
AU - Werlin, Steven L.
AU - Wilschanski, Michael
AU - Barth, Bradley
AU - Fishman, Douglas S.
AU - Freedman, Steven D.
AU - Giefer, Matthew J.
AU - Gonska, Tanja
AU - Himes, Ryan
AU - Husain, Sohail Z.
AU - Morinville, Veronique D.
AU - Ooi, Chee Y.
AU - Schwarzenberg, Sarah J.
AU - Troendle, David M.
AU - Yen, Elizabeth
AU - Uc, Aliye
N1 - Publisher Copyright:
© Copyright 2016 ESPGHAL and NASPGHAN. All rights reserved.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017
Y1 - 2017
N2 - Objectives: Acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) have been diagnosed in children at increasing rates during the past decade. As pediatric ARP and CP are still relatively rare conditions, little quality evidence is available on which to base the diagnosis and determination of etiology. The aim of the study was to review the current state of the literature regarding the etiology of these disorders and to developed a consensus among a panel of clinically active specialists caring for children with these disorders to help guide the diagnostic evaluation and identify areas most in need of future research. Methods: A systematic review of the literature was performed and scored for quality, followed by consensus statements developed and scored by each individual in the group for level of agreement and strength of the supporting data using a modified Delphi method. Scores were analyzed for the level of consensus achieved by the group. Results: The panel reached consensus on 27 statements covering the definitions of pediatric ARP and CP, evaluation for potential etiologies of these disorders, and long-term monitoring. Statements for which the group reached consensus to make no recommendation or could not reach consensus are discussed. Conclusions: This consensus helps define the minimal diagnostic evaluation and monitoring of children with ARP and CP. Even in areas in which we reached consensus, the quality of the evidence is weak, highlighting the need for further research. Improved understanding of the underlying cause will facilitate treatment development and targeting.
AB - Objectives: Acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) have been diagnosed in children at increasing rates during the past decade. As pediatric ARP and CP are still relatively rare conditions, little quality evidence is available on which to base the diagnosis and determination of etiology. The aim of the study was to review the current state of the literature regarding the etiology of these disorders and to developed a consensus among a panel of clinically active specialists caring for children with these disorders to help guide the diagnostic evaluation and identify areas most in need of future research. Methods: A systematic review of the literature was performed and scored for quality, followed by consensus statements developed and scored by each individual in the group for level of agreement and strength of the supporting data using a modified Delphi method. Scores were analyzed for the level of consensus achieved by the group. Results: The panel reached consensus on 27 statements covering the definitions of pediatric ARP and CP, evaluation for potential etiologies of these disorders, and long-term monitoring. Statements for which the group reached consensus to make no recommendation or could not reach consensus are discussed. Conclusions: This consensus helps define the minimal diagnostic evaluation and monitoring of children with ARP and CP. Even in areas in which we reached consensus, the quality of the evidence is weak, highlighting the need for further research. Improved understanding of the underlying cause will facilitate treatment development and targeting.
KW - Autoimmune pancreatitis
KW - CFTR
KW - Hereditary pancreatitis
KW - PRSS1
KW - Pancreatic insufficiency
UR - http://www.scopus.com/inward/record.url?scp=84992401844&partnerID=8YFLogxK
U2 - 10.1097/MPG.0000000000001446
DO - 10.1097/MPG.0000000000001446
M3 - Article
C2 - 27782962
AN - SCOPUS:84992401844
VL - 64
SP - 95
EP - 103
JO - Journal of Pediatric Gastroenterology and Nutrition
JF - Journal of Pediatric Gastroenterology and Nutrition
SN - 0277-2116
IS - 1
ER -