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Pediatric Drug-Associated Pancreatitis Reveals Concomitant Risk Factors and Poor Reliability of Causality Scoring: Report From INSPPIRE.
Morinville, Veronique D; Husain, Sohail Z; Wang, Fuchenchu; Cress, Gretchen A; Abu-El-Haija, Maisam; Chugh, Ankur; Downs, Elissa; Ellery, Kate; Fishman, Douglas S; Freeman, Alvin Jay; Gariepy, Cheryl E; Giefer, Matthew; Gonska, Tanja; Liu, Quin; Maqbool, Asim; Mark, Jacob; Mcferron, Brian Arthur; Mehta, Megha; Nathan, Jaimie D; Ng, Ken; Ooi, Chee Y; Perito, Emily; Ruan, Wenly; Schwarzenberg, Sarah Jane; Sellers, Zachary M; Serrano, Jose; Troendle, David M; Wilschanski, Michael; Zheng, Yuhua; Yuan, Ying; Lowe, Mark; Uc, Aliye.
Afiliação
  • Morinville VD; From The Montreal Children's Hospital, McGill University, Montreal, QC, Canada.
  • Husain SZ; The Stanford University, Palo Alto, CA.
  • Wang F; The University of Texas, MD Anderson Cancer Center, Houston, TX.
  • Cress GA; The University of Iowa, Stead Family Children's Hospital, Iowa City, IA.
  • Abu-El-Haija M; The Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, OH.
  • Chugh A; The Medical College of Wisconsin, Milwaukee, WI.
  • Downs E; The University of Minnesota Masonic Children's Hospital, Minneapolis, MN.
  • Ellery K; The Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.
  • Fishman DS; The Division of Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine and Texas Children's Hospital, Houston, TX.
  • Freeman AJ; The Nationwide Children's Hospital, Columbus, OH.
  • Gariepy CE; The Nationwide Children's Hospital, Columbus, OH.
  • Giefer M; The Ochsner Hospital for Children, Jefferson, LA.
  • Gonska T; The Hospital for Sick Children, Toronto, ON, Canada.
  • Liu Q; The Cedars-Sinai Medical Center, Los Angeles, CA.
  • Maqbool A; The Children's Hospital of Philadelphia, Philadelphia, PA.
  • Mark J; the Children's Hospital Colorado, Aurora, CO.
  • Mcferron BA; The Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN.
  • Mehta M; The University of Texas Southwestern Medical Center, Dallas, TX.
  • Nathan JD; The Nationwide Children's Hospital, Columbus, OH.
  • Ng K; The John Hopkins Medical Center, Baltimore, MD.
  • Ooi CY; The School of Women's and Children's Health, Faculty of Medicine, University of New South Wales and Sydney Children's Hospital Randwick, Sydney, NSW, Australia.
  • Perito E; The University of California San Francisco Medical Center, San Francisco, CA.
  • Ruan W; The Nationwide Children's Hospital, Columbus, OH.
  • Schwarzenberg SJ; The University of Minnesota Masonic Children's Hospital, Minneapolis, MN.
  • Sellers ZM; The Stanford University, Palo Alto, CA.
  • Serrano J; the Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Bethesda, MD.
  • Troendle DM; The University of Texas Southwestern Medical Center, Dallas, TX.
  • Wilschanski M; The Hadassah Hebrew University Hospital, Jerusalem, Israel.
  • Zheng Y; The Children's Hospital of Los Angeles, Los Angeles, CA.
  • Yuan Y; The University of Texas, MD Anderson Cancer Center, Houston, TX.
  • Lowe M; The Washington University School of Medicine, St Louis, MO.
  • Uc A; The University of Iowa, Stead Family Children's Hospital, Iowa City, IA.
J Pediatr Gastroenterol Nutr ; 77(4): 540-546, 2023 10 01.
Article em En | MEDLINE | ID: mdl-37496124
ABSTRACT

OBJECTIVES:

Drug-associated acute pancreatitis (DAP) studies typically focus on single acute pancreatitis (AP) cases. We aimed to analyze the (1) characteristics, (2) co-risk factors, and (3) reliability of the Naranjo scoring system for DAP using INSPPIRE-2 (the INternational Study group of Pediatric Pancreatitis In search for a cuRE-2) cohort study of acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) in children.

METHODS:

Data were obtained from ARP group with ≥1 episode of DAP and CP group with medication exposure ± DAP. Physicians could report multiple risk factors. Pancreatitis associated with Medication (Med) (ARP+CP) was compared to Non-Medication cases, and ARP-Med vs CP-Med groups. Naranjo score was calculated for each DAP episode.

RESULTS:

Of 726 children, 392 had ARP and 334 had CP; 51 children (39 ARP and 12 CP) had ≥1 AP associated with a medication; 61% had ≥1 AP without concurrent medication exposure. The Med group had other risk factors present (where tested) 10 of 35 (28.6%) genetic, 1 of 48 (2.1%) autoimmune pancreatitis, 13 of 51 (25.5%) immune-mediated conditions, 11 of 50 (22.0%) obstructive/anatomic, and 28 of 51 (54.9%) systemic risk factors. In Med group, 24 of 51 (47%) had involvement of >1 medication, simultaneously or over different AP episodes. There were 20 ARP and 4 CP cases in "probable" category and 19 ARP and 7 CP in "possible" category by Naranjo scores.

CONCLUSIONS:

Medications were involved in 51 of 726 (7%) of ARP or CP patients in INSPPIRE-2 cohort; other pancreatitis risk factors were present in most, suggesting a potential additive role of different risks. The Naranjo scoring system failed to identify any cases as "definitive," raising questions about its reliability for DAP.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Pancreatite Crônica Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Humans Idioma: En Revista: J Pediatr Gastroenterol Nutr Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Canadá
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Pancreatite Crônica Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Humans Idioma: En Revista: J Pediatr Gastroenterol Nutr Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Canadá