Pediatric Drug-Associated Pancreatitis Reveals Concomitant Risk Factors and Poor Reliability of Causality Scoring: Report From INSPPIRE.

Autor: Morinville VD; From The Montreal Children's Hospital, McGill University, Montreal, QC, Canada., Husain SZ; The Stanford University, Palo Alto, CA., Wang F; The University of Texas, MD Anderson Cancer Center, Houston, TX., Cress GA; The University of Iowa, Stead Family Children's Hospital, Iowa City, IA., Abu-El-Haija M; The Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, OH., Chugh A; The Medical College of Wisconsin, Milwaukee, WI., Downs E; The University of Minnesota Masonic Children's Hospital, Minneapolis, MN., Ellery K; The Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA., Fishman DS; The Division of Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine and Texas Children's Hospital, Houston, TX., Freeman AJ; The Nationwide Children's Hospital, Columbus, OH., Gariepy CE; The Nationwide Children's Hospital, Columbus, OH., Giefer M; The Ochsner Hospital for Children, Jefferson, LA., Gonska T; The Hospital for Sick Children, Toronto, ON, Canada., Liu Q; The Cedars-Sinai Medical Center, Los Angeles, CA., Maqbool A; The Children's Hospital of Philadelphia, Philadelphia, PA., Mark J; the Children's Hospital Colorado, Aurora, CO., Mcferron BA; The Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN., Mehta M; The University of Texas Southwestern Medical Center, Dallas, TX., Nathan JD; The Nationwide Children's Hospital, Columbus, OH., Ng K; The John Hopkins Medical Center, Baltimore, MD., Ooi CY; The School of Women's and Children's Health, Faculty of Medicine, University of New South Wales and Sydney Children's Hospital Randwick, Sydney, NSW, Australia., Perito E; The University of California San Francisco Medical Center, San Francisco, CA., Ruan W; The Nationwide Children's Hospital, Columbus, OH., Schwarzenberg SJ; The University of Minnesota Masonic Children's Hospital, Minneapolis, MN., Sellers ZM; The Stanford University, Palo Alto, CA., Serrano J; the Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Bethesda, MD., Troendle DM; The University of Texas Southwestern Medical Center, Dallas, TX., Wilschanski M; The Hadassah Hebrew University Hospital, Jerusalem, Israel., Zheng Y; The Children's Hospital of Los Angeles, Los Angeles, CA., Yuan Y; The University of Texas, MD Anderson Cancer Center, Houston, TX., Lowe M; The Washington University School of Medicine, St Louis, MO., Uc A; The University of Iowa, Stead Family Children's Hospital, Iowa City, IA.
Jazyk: angličtina
Zdroj: Journal of pediatric gastroenterology and nutrition [J Pediatr Gastroenterol Nutr] 2023 Oct 01; Vol. 77 (4), pp. 540-546. Date of Electronic Publication: 2023 Jul 27.
DOI: 10.1097/MPG.0000000000003898
Abstrakt: Objectives: Drug-associated acute pancreatitis (DAP) studies typically focus on single acute pancreatitis (AP) cases. We aimed to analyze the (1) characteristics, (2) co-risk factors, and (3) reliability of the Naranjo scoring system for DAP using INSPPIRE-2 (the INternational Study group of Pediatric Pancreatitis: In search for a cuRE-2) cohort study of acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) in children.
Methods: Data were obtained from ARP group with ≥1 episode of DAP and CP group with medication exposure ± DAP. Physicians could report multiple risk factors. Pancreatitis associated with Medication (Med) (ARP+CP) was compared to Non-Medication cases, and ARP-Med vs CP-Med groups. Naranjo score was calculated for each DAP episode.
Results: Of 726 children, 392 had ARP and 334 had CP; 51 children (39 ARP and 12 CP) had ≥1 AP associated with a medication; 61% had ≥1 AP without concurrent medication exposure. The Med group had other risk factors present (where tested): 10 of 35 (28.6%) genetic, 1 of 48 (2.1%) autoimmune pancreatitis, 13 of 51 (25.5%) immune-mediated conditions, 11 of 50 (22.0%) obstructive/anatomic, and 28 of 51 (54.9%) systemic risk factors. In Med group, 24 of 51 (47%) had involvement of >1 medication, simultaneously or over different AP episodes. There were 20 ARP and 4 CP cases in "probable" category and 19 ARP and 7 CP in "possible" category by Naranjo scores.
Conclusions: Medications were involved in 51 of 726 (7%) of ARP or CP patients in INSPPIRE-2 cohort; other pancreatitis risk factors were present in most, suggesting a potential additive role of different risks. The Naranjo scoring system failed to identify any cases as "definitive," raising questions about its reliability for DAP.
Competing Interests: Dr Lowe is on the Board of Directors of the National Pancreas Association and receives royalties from Millipore Inc and UpToDate. Dr Gonska received a research grant from Vertex Pharmaceuticals, and she is a consultant for Cystic Fibrosis Foundation (CFF). Dr Uc is a member of American Board of Pediatrics, Subboard of Pediatric Gastroenterology, Associate Editor of Pancreatology , and consultant for CFF. Dr Schwarzenberg is a consultant for UpToDate, Nestle, AbbVie, and the CFF, and she has a grant from Gilead. Dr Troendle is an Associate Editor for JPGN . Dr Morinville is an Associate Editor for JPGN Reports . The remaining authors report no conflicts of interest.
(Copyright © 2023 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
Databáze: MEDLINE
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