Rapid Progression of Acute Pancreatitis to Acute Recurrent Pancreatitis in Children.
Rapid Progression of Acute Pancreatitis to Acute Recurrent Pancreatitis in Children.
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DOI：
10.1097/mpg.0000000000002145
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发表时间：
2019-01
影响因子：
2.9
通讯作者：
Abu-El-Haija M
中科院分区：
文献类型：
--
作者：
Sweeny KF;Lin TK;Nathan JD;Denson LA;Husain SZ;Hornung L;Thompson T;Abu-El-Haija M
缺乏关于急性胰腺炎（AP）进展为急性复发性胰腺炎（ARP）的自然史的研究。 The aim of this project was to study the progression from AP to ARP among pediatric patients with pancreatitis to better understand the presentation and natural history of pancreatitis.患有 AP 的患者被纳入研究电子数据捕获的前瞻性数据库中。 We enrolled 115 AP patients from March 2013 – November 2016. Physicians completed surveys regarding clinical data for patients with first attack of AP.对患者进行前瞻性随访，并在患者出现 ARP 时输入进展数据。 AP 首次发作最常见的病因是特发性 (31%)、中毒/药物相关 (23%) 和胆结石/胆结石 (18%)。 115 名患者中有 20 名 (17%) 在随访期间出现了 ARP。 Seventy percent (14/20) of ARP patients progressed from AP to ARP within 5 months from first diagnosis. A comparison of patients who rapidly progressed to ARP within 3 months (n=12) to those followed for more than 3 months without progression in 3 months (n=97) revealed associations with a higher weight percentile for age (p=0.045), male gender (p=0.03) and presence of pancreatic necrosis during first AP attack (p=0.004). Progression to ARP significantly differed by etiology group with genetics having the highest risk for ARP progression over time and patients with gallstone/biliary, viral/systemic, and obstructive (non-gallstone) having the lowest risk for ARP progression over time (p=0.02).大多数从 AP 进展为 ARP 的患者在五个月内进展。 The presence of a higher weight percentile for age, male gender and pancreatic necrosis during the first AP attack are associated with rapid progression to ARP.
Research is lacking on the natural history of acute pancreatitis (AP) progression to acute recurrent pancreatitis (ARP). The aim of this project was to study the progression from AP to ARP among pediatric patients with pancreatitis to better understand the presentation and natural history of pancreatitis. Patients presenting with AP were included in a prospective database in Research Electronic Data Capture. We enrolled 115 AP patients from March 2013 – November 2016. Physicians completed surveys regarding clinical data for patients with first attack of AP. Patients were followed prospectively, with data on progression entered when patients presented with ARP. The most common etiologies for the first attack of AP were idiopathic (31%), toxic/drug related (23%), and biliary/gallstone (18%). Twenty of the 115 patients (17%) developed ARP during the follow up period. Seventy percent (14/20) of ARP patients progressed from AP to ARP within 5 months from first diagnosis. A comparison of patients who rapidly progressed to ARP within 3 months (n=12) to those followed for more than 3 months without progression in 3 months (n=97) revealed associations with a higher weight percentile for age (p=0.045), male gender (p=0.03) and presence of pancreatic necrosis during first AP attack (p=0.004). Progression to ARP significantly differed by etiology group with genetics having the highest risk for ARP progression over time and patients with gallstone/biliary, viral/systemic, and obstructive (non-gallstone) having the lowest risk for ARP progression over time (p=0.02). Most patients who progressed from AP to ARP progressed within five months. The presence of a higher weight percentile for age, male gender and pancreatic necrosis during the first AP attack are associated with rapid progression to ARP.