A Better Understanding of Pediatric Autoimmune Pancreatitis: Over 13 Years of Experience.
J Pediatr Gastroenterol Nutr
; 76(5): 640-645, 2023 05 01.
Article
em En
| MEDLINE
| ID: mdl-36763993
ABSTRACT
OBJECTIVES:
Pediatric autoimmune pancreatitis (P-AIP) is an uncommon disease whose diagnosis requires strong clinical suspicion. Late diagnosis increases morbidity. We aimed to compare the usefulness of the 2011 International Consensus Diagnostic Criteria (ICDC) for Autoimmune Pancreatitis with the 2018 INSPPIRE (INternational Study Group of Pediatric Pancreatitis In search for a cuRE) criteria.METHODS:
We retrospectively analyzed demographics and clinical, laboratory, radiological, and histological findings at diagnosis and during long-term follow-up in children diagnosed with AIP in 2 tertiary hospitals between 2008 and 2021.RESULTS:
We included 11 patients [6 girls; median age at diagnosis, 12.5 (range 2.8-15.7) years]. The most common symptom was abdominal pain. Pancreatic enzymes were elevated in 10 patients, and serum immunoglobulin G4 was elevated in 1. Magnetic resonance imaging showed enlargement of the pancreatic head in 10 patients and general pancreatic enlargement in 1. Pancreatic and papilla tissue were obtained from 9 patients. All patients received corticosteroids (prednisolone), and 4 also received azathioprine. According to the ICDC, all patients were classified as probable or non-otherwise specified AIP. According to INSPPIRE criteria, all patients were classified as AIP. Using the INSPPIRE criteria would have avoided biopsies in 6 patients who responded well to corticosteroids.CONCLUSIONS:
The INSPPIRE criteria are useful. Using the ICDC in pediatric patients can delay diagnosis and result in unnecessary invasive tests.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doenças Autoimunes
/
Pancreatite Autoimune
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
Limite:
Adolescent
/
Child
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Child, preschool
/
Female
/
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article