Chronic Pancreatitis: Pediatric and Adult Cohorts Show Similarities in Disease Progress Despite Different Risk Factors.
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Schwarzenberg Sarah J, Uc Aliye, Zimmerman Bridget, Wilschanski Michael, Wilcox C Mel, Whitcomb David C, Werlin Steven L, Troendle David, Tang Gong, Slivka Adam, Singh Vikesh K, Sherman Stuart, Shah Uzma, Sandhu Bimaljit S, Romagnuolo Joseph, Rhee Sue, Pohl John F, Perito Emily R, Ooi Chee Y, Nathan Jaimie D, Muniraj Thiruvengadam, Morinville Veronique D, McFerron Brian, Mascarenhas Maria, Maqbool Asim, Liu Quin, Lin Tom K, Lewis Michele, Husain Sohail Z, Himes Ryan, Heyman Melvin B, Guda Nalini, Gonska Tanja, Giefer Matthew J, Gelrud Andres, Gariepy Cheryl E, Gardner Timothy B, Freedman Steven D, Forsmark Christopher E, Fishman Douglas S, Cote Gregory A, Conwell Darwin, Brand Randall E, Bellin Melena, Barth Bradley, Banks Peter A, Anderson Michelle A, Amann Stephen T, Alkaade Samer, Abu-El-Haija Maisam, Abberbock Judah N, Lowe Mark E, Yadav Dhiraj
Аннотация
METHODS: Demographics, risk factors, disease duration, management and outcomes of 224 children and 1063 adults were compared using appropriate statistical tests for categorical and continuous variables.
RESULTS: Alcohol was a risk in 53% of adults and 1% of children (P < 0.0001); tobacco in 50% of adults and 7% of children (P < 0.0001). Obstructive factors were more common in children (29% vs 19% in adults, P = 0.001). Genetic risk factors were found more often in children. Exocrine pancreatic insufficiency was similar (children 26% vs adult 33%, P = 0.107). Diabetes was more common in adults than children (36% vs 4% respectively, P < 0.0001). Median emergency room visits, hospitalizations, and missed days of work/school were similar across the cohorts. As a secondary analysis, NAPS2 subjects with childhood onset (NAPS2-CO) were compared with INSPPIRE subjects. These 2 cohorts were more similar than the total INSPPIRE and NAPS2 cohorts, including for genetic risk factors. The only risk factor significantly more common in the NAPS2-CO cohort compared with the INSPPIRE cohort was alcohol (9% NAPS2-CO vs 1% INSPPIRE cohorts, P = 0.011).
CONCLUSIONS: Despite disparity in age of onset, children and adults with CP exhibit similarity in demographics, CP treatment, and pain. Differences between groups in radiographic findings and diabetes prevalence may be related to differences in risk factors associated with disease and length of time of CP.