IntroductionThe acute pancreatitis is a rare disease, but it has started to be diagnosed more often in children.AimThe aim of the study was single-centre, retrospective analysis of the incidence, aetiology, and clinical course of acute pancreatitis in children.Material and methodsWe analysed the medical records of patients with acute pancreatitis hospitalised in the Gastroenterology Unit of the Paediatrics Department, Medical University of Silesia from Jan 2004 to Dec 2013.ResultsThere were 76 cases of acute pancreatitis among 51 children (average age: 12.07 years) hospitalised in the Gastroenterology Unit between January 2004 and December 2013. The diagnosis of acute pancreatitis was performed on the basis of INSPIRE criteria and modified Atlanta classification. Patients were divided into groups: I – 1–12 years old, which included 20 (39.21%) children and II – 13–18 years old, with 31 (60.78%) children. The idiopathic aetiology was the most common cause of acute pancreatitis, occurring in 22 (43.1%) children, and in 15 cases the aetiology of the disease was biliary (29.4%). Genetically determined causes were diagnosed in 8 (15.7%) patients, the PRSS1 mutation in four patients, mutation in SPINK1 in 1 child, and CFTR gene mutation in 1 child. Two children simultaneously had two genes mutations (CFTR, SPINK1), and during the considered period had more than one episode of acute pancreatitis.ConclusionsAcute pancreatitis of idiopathic aetiology was most common among the examined children, and this should encourage the continued search for the causes of disease, especially genetic, and with particular emphasis on younger age group.

Oxidative stress (OS) has been recently implicated in the disease pathogenesis in inflammatory bowel disease (IBD). The aim of the study was to evaluate oxidative and antioxidative stress status and the risk of the atherosclerotic process in children with IBD and functional gastrointestinal disorders (FGID). The prospective study included a group of 71 children during a period of 2 years. In all children, laboratory tests were performed and intima-media complex in the carotid artery was measured (IMC). Low values of OS were more frequent in children with IBD than in the FGID group. The average concentration of oxidized lipoprotein with average density (oxLDL) was lower in patients with IBD. Among patients with IBD, higher concentrations of oxLDL were recorded in patients with longer-duration disease and with higher concentrations of total cholesterol. In the IBD group, more often, higher concentrations of anti-oxLDL were recorded among patients with longer-duration disease. The obtained results did not support the hypothesis of total antioxidant capacity depletion and greater overall OS in patients with IBD. Patients with IBD with a longer duration of the disease have higher concentrations of oxLDL and anti-oxLDL.

Background Insufficient vitamin D and calcium intake associated with the restricted intake of milk and dairy products can lead to poor health outcomes like malnutrition and abnormal bone mineralization. The aim of the study was to estimate the prevalence of primary and secondary lactose intolerance in children with IBD. Methods The study included 107 patients (mean age 14.07 ± 3.58 years; 46.7% boys) which includes 43 patients with Crohn's disease (CD), 31 with ulcerative colitis (UC), and 33 children with functional abdominal pain (AP-FGID). We analysed the result of the hydrogen breath test with lactose loading, two single nucleotide polymorphisms of the LCT gene (LCT-13910CC and LCT-22018GG). The results were analysed with MedCalc Statistical Software. Results Adult-type hypolactasia (ATH) was found in 31% of patients with IBD and 42.4% of AP-FGID (p = 0.2). Lactose malabsorption (LM) was found in 27.9% of patients with CD, in 22.6% with UC, and in 24.2% with AP-FGID (p = 0.8). Lactose intolerance (LI) was diagnosed in a similar percentage of patients in each group (p = 0.9). Secondary LI in IBD patients does not depend on the location, duration, and activity of the disease and the number of relapses (p > 0.05). The median time of lactose-free diet in CD was 10 months and in CU 24 months. Conclusions The incidence of LI, LM, and ATH does not differ among children with IBD from the population.

Background: A diet restricted in dairy products can cause calcium and vitamin D deficiency and, secondarily, lead to malnutrition and low bone mass. The aim of the study was to determine the incidence hypocalcemia and vitamin D deficiency in children with inflammatory bowel diseases and lactose intolerance (LI). Material and Methods: A total of 107 patients were enrolled to the study (mean age 14.07 ± 3.58 years; 46.7% boys): 43 with Crohn’s disease (CD), 31 with ulcerative colitis (UC), and 33 with functional abdominal pain (AP-FGID). Hydrogen breath test with lactose and laboratory tests to assess the calcium-phosphate metabolism were performed in all patients. The results of densitometry were interpreted in 37 IBD patients. Results: LI was diagnosed in 23.2% patients with CD, 22.6% with UC, and 21.2% children with AP-FGID, (p = 0.9). Moreover, 9.5% patients with CD, in 21.4% with UC, and in 51.5% with AP-FGID had optimal concentration of 25(OH)D (p = 0.0002). Hypocalcemia was diagnosed in 21% of patients with CD, 16.1% with UC patients, AP-FGID patients had normal calcium levels (p = 0.02). There was no difference in concentrations of total calcium, phosphorus, and 25(OH)D between patients on low-lactose diet and normal diet (p > 0.05). BMD Z-score ≤ −1 SD was obtained by 12 CD patients (48%), and 6 with UC (50%). Conclusion: The use of a low-lactose diet in the course of lactose intolerance in children with inflammatory bowel diseases has no effect on the incidence of calcium-phosphate disorders and reduced bone mineral density.

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