Incidence and Clinical Associations of Childhood Acute Pancreatitis

Abdalmonem Majbar, Eleri Cusick, Paul Johnson, Richard Lynn, Linda Hunt, Julian Hamilton-Shield

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Abstract

OBJECTIVES: To establish the UK incidence and clinical associations of acute pancreatitis (AP) in children aged 0 to 14 years. METHODS: Monthly surveillance of new cases of AP in children under 15 years of age through the British Pediatric Surveillance Unit conducted from April 2013 to April 2014 (inclusive) followed by 1-year administrative follow-up for all valid cases. RESULTS: Ninety-four cases (48 boys) fulfilled the diagnostic criteria. The median age at diagnosis was 11.2 years (range 1.3–14.9). White children accounted for 61% of the cases compared with 28% from Asian and 5% from African ethnicities. Pakistani children accounted for 18 of 26 (69%) Asian patients and 19% of the total cohort. The incidence of AP in children in the United Kingdom was 0.78 per 100 000/year (95% confidence interval [CI] 0.62–0.96). The incidence in Pakistani children (4.55; 95% CI 2.60–7.39) was sevenfold greater than white children (0.63; 95% CI 0.47–0.83). Of the 94 cases, 35 (37%) were idiopathic; other associations were: drug therapy, 18 (19%); gallstones, 12 (13%); hereditary, 7 (7%); organic acidemias, 7 (7%); anatomic anomalies, 5 (5%); viral infections, 3 (3%); systemic diseases, 2 (2%); and trauma 1 (1%). The most common drug associations were asparaginase (28%), azathioprine (17%), and sodium valproate (17%). CONCLUSIONS: Although still relatively uncommon in the United Kingdom, on average there is >1 case of childhood AP diagnosed every week. The associations of AP have changed significantly since the 1970–80s. Overrepresentation of Pakistani children is worthy of further investigation. Abbreviations: AP — acute pancreatitis BPSU — British Paediatric Surveillance Unit CI — confidence interval RCPCH — Royal College of Paediatrics and Child Health
Original languageEnglish
Article numbere 20161198
Number of pages9
JournalPediatrics
Volume138
Issue number3
DOIs
Publication statusPublished - 17 Aug 2016

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