Novel Characterization of Drug‐associated Pancreatitis in Children

Abstract

Background and Objectives Medications are a major cause of acute pancreatitis; however, little is known about their influence in children. Our primary aims were to identify common comorbidities and concomitant pancreatitis etiologies in children with drug-associated pancreatitis. Our secondary aims were to identify the most commonly associated drugs in the different age groups, evaluate management practices, and compare drug-associated cases with non–drug-associated cases. Patients and Methods In the present study, we examined children (ages 0–20 years) admitted to Yale-New Haven Children’s Hospital with pancreatitis between 1994 and 2007. Results Of a total of 271 pediatric cases, drugs were associated with pancreatitis in 25.6% (55). The 3 most common comorbidities in children with drug-associated pancreatitis were seizure disorders, acute lymphocytic leukemia, and Crohn disease. One third of drug-associated cases had an additional pancreatitis etiology. The most commonly associated drugs were valproic acid and corticosteroids. Compared with non–drug-associated cases, children with drug-associated cases were more likely to undergo CT scanning (54.5% vs 28.4%; P < 0.001), stay in the hospital longer (10 vs 4 days; P < 0.001), and transition to parenteral nutrition from a nil per os status (37.5% vs 21.2%; P < 0.05). There was a higher frequency of valproic acid–associated cases in children younger than 11 years (29.4% vs 9.5% in the 11- to 20-year-old age group). Conclusions Our study underscores the importance of considering drugs as a cause and a contributor to pancreatitis in children, particularly valproic acid in young children.

Extensive Molecular Analysis Suggested the Strong Genetic Heterogeneity of Idiopathic Chronic Pancreatitis

“…Such causes are uncommon in pediatric pancreatitis, where a percentage of the cases are due to congenital pancreatic malformations. More rare causes include trauma and drugs (4).…”

Rufinamide kullanımı sonrası gelişen akut pankreatit: Olgu Sunumu

“…Akut pankreatit ortak safra kanalı taşı, ilaçlar, sistemik hastalıklar, travma, metabolik hastalık-lar ve herediter nedenlere bağlı olabilmektedir (1,2). İlaca bağlı pankreatit çocuk hastalarda ya-pılan bir çalışmada %25,6 oranında tespit edil-miştir.…”

“…En sık etken olan ilaçlar valproik asit ve steroidler,meselamin iken ilaca bağlı pankreatite en sık eşlik eden hastalıklar epilepsi, akut lenfo-sitik lösemi, crohn hastalığıdır. İlaca bağlı pank-reatitte daha az sıklıktaki görülen diğer ilaçlar ise trimeoprimsülfametaksazol, 6-merkaptopurin, asparaginaz, azotioprin, vincristin, furosemid, pentamidin, hidroklorotiyazidtir (2 …”

Alpers-Huttenlocher Syndrome

“…It is tempting to invoke pancreatitis to valproic acid exposure. Especially, since valproic acid induction of pancreatitis is a well-known side effect in patients with epilepsy [50]. However, Harding [5] reported pancreatitis in patients not exposed to valproic acid.…”