Chronic Pancreatitis: Pediatric and Adult Cohorts Show Similarities in Disease Progress Despite Different Risk Factors

Sarah J Schwarzenberg, Aliye Uc, Bridget Zimmerman, Michael Wilschanski, C. Mel Wilcox, David C. Whitcomb, Steven L. Werlin, David Troendle, Gong Tang, Adam Slivka, Vikesh K. Singh, Stuart Sherman, Uzma Shah, Bimaljit S. Sandhu, Joseph Romagnuolo, Sue Rhee, John F. Pohl, Emily R. Perito, Chee Y. Ooi, Jaimie D. NathanThiruvengadam Muniraj, Veronique D. Morinville, Brian McFerron, Maria Mascarenhas, Asim Maqbool, Quin Liu, Tom K. Lin, Michele Lewis, Sohail Z. Husain, Ryan Himes, Melvin B. Heyman, Nalini Guda, Tanja Gonska, Matthew J. Giefer, Andres Gelrud, Cheryl E. Gariepy, Timothy B. Gardner, Steven D. Freedman, Christopher E. Forsmark, Douglas S. Fishman, Gregory A. Cote, Darwin Conwell, Randall E. Brand, Melena D Bellin, Bradley Barth, Peter A. Banks, Michelle A. Anderson, Stephen T. Amann, Samer Alkaade, Maisam Abu-El-Haija, Judah N. Abberbock, Mark E. Lowe, Dhiraj Yadav

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: The aim of the present study was to investigate the natural history of chronic pancreatitis (CP); patients in the North American Pancreatitis Study2 (NAPS2, adults) and INternational Study group of Pediatric Pancreatitis: In search for a cuRE (INSPPIRE, pediatric) were compared. 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.

Original languageEnglish (US)
Pages (from-to)566-573
Number of pages8
JournalJournal of pediatric gastroenterology and nutrition
Volume68
Issue number4
DOIs
StatePublished - Apr 1 2019

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Chronic Pancreatitis
Pediatrics
Pancreatitis
Alcohols
Demography
Exocrine Pancreatic Insufficiency
Disease Management
Age of Onset
Chronic Pain
Tobacco
Hospital Emergency Service
Hospitalization

PubMed: MeSH publication types

  • Journal Article

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Chronic Pancreatitis : Pediatric and Adult Cohorts Show Similarities in Disease Progress Despite Different Risk Factors. / 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 D; 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.

In: Journal of pediatric gastroenterology and nutrition, Vol. 68, No. 4, 01.04.2019, p. 566-573.

Research output: Contribution to journalArticle

Schwarzenberg, SJ, Uc, A, Zimmerman, B, Wilschanski, M, Wilcox, CM, Whitcomb, DC, Werlin, SL, Troendle, D, Tang, G, Slivka, A, Singh, VK, Sherman, S, Shah, U, Sandhu, BS, Romagnuolo, J, Rhee, S, Pohl, JF, Perito, ER, Ooi, CY, Nathan, JD, Muniraj, T, Morinville, VD, McFerron, B, Mascarenhas, M, Maqbool, A, Liu, Q, Lin, TK, Lewis, M, Husain, SZ, Himes, R, Heyman, MB, Guda, N, Gonska, T, Giefer, MJ, Gelrud, A, Gariepy, CE, Gardner, TB, Freedman, SD, Forsmark, CE, Fishman, DS, Cote, GA, Conwell, D, Brand, RE, Bellin, MD, Barth, B, Banks, PA, Anderson, MA, Amann, ST, Alkaade, S, Abu-El-Haija, M, Abberbock, JN, Lowe, ME & Yadav, D 2019, 'Chronic Pancreatitis: Pediatric and Adult Cohorts Show Similarities in Disease Progress Despite Different Risk Factors', Journal of pediatric gastroenterology and nutrition, vol. 68, no. 4, pp. 566-573. https://doi.org/10.1097/MPG.0000000000002279
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 D ; 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. / Chronic Pancreatitis : Pediatric and Adult Cohorts Show Similarities in Disease Progress Despite Different Risk Factors. In: Journal of pediatric gastroenterology and nutrition. 2019 ; Vol. 68, No. 4. pp. 566-573.
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abstract = "OBJECTIVES: The aim of the present study was to investigate the natural history of chronic pancreatitis (CP); patients in the North American Pancreatitis Study2 (NAPS2, adults) and INternational Study group of Pediatric Pancreatitis: In search for a cuRE (INSPPIRE, pediatric) were compared. 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.",
author = "Schwarzenberg, {Sarah J} and Aliye Uc and Bridget Zimmerman and Michael Wilschanski and Wilcox, {C. Mel} and Whitcomb, {David C.} and Werlin, {Steven L.} and David Troendle and Gong Tang and Adam Slivka and Singh, {Vikesh K.} and Stuart Sherman and Uzma Shah and Sandhu, {Bimaljit S.} and Joseph Romagnuolo and Sue Rhee and Pohl, {John F.} and Perito, {Emily R.} and Ooi, {Chee Y.} and Nathan, {Jaimie D.} and Thiruvengadam Muniraj and Morinville, {Veronique D.} and Brian McFerron and Maria Mascarenhas and Asim Maqbool and Quin Liu and Lin, {Tom K.} and Michele Lewis and Husain, {Sohail Z.} and Ryan Himes and Heyman, {Melvin B.} and Nalini Guda and Tanja Gonska and Giefer, {Matthew J.} and Andres Gelrud and Gariepy, {Cheryl E.} and Gardner, {Timothy B.} and Freedman, {Steven D.} and Forsmark, {Christopher E.} and Fishman, {Douglas S.} and Cote, {Gregory A.} and Darwin Conwell and Brand, {Randall E.} and Bellin, {Melena D} and Bradley Barth and Banks, {Peter A.} and Anderson, {Michelle A.} and Amann, {Stephen T.} and Samer Alkaade and Maisam Abu-El-Haija and Abberbock, {Judah N.} and Lowe, {Mark E.} and Dhiraj Yadav",
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TY - JOUR

T1 - Chronic Pancreatitis

T2 - Pediatric and Adult Cohorts Show Similarities in Disease Progress Despite Different Risk Factors

AU - Schwarzenberg, Sarah J

AU - Uc, Aliye

AU - Zimmerman, Bridget

AU - Wilschanski, Michael

AU - Wilcox, C. Mel

AU - Whitcomb, David C.

AU - Werlin, Steven L.

AU - Troendle, David

AU - Tang, Gong

AU - Slivka, Adam

AU - Singh, Vikesh K.

AU - Sherman, Stuart

AU - Shah, Uzma

AU - Sandhu, Bimaljit S.

AU - Romagnuolo, Joseph

AU - Rhee, Sue

AU - Pohl, John F.

AU - Perito, Emily R.

AU - Ooi, Chee Y.

AU - Nathan, Jaimie D.

AU - Muniraj, Thiruvengadam

AU - Morinville, Veronique D.

AU - McFerron, Brian

AU - Mascarenhas, Maria

AU - Maqbool, Asim

AU - Liu, Quin

AU - Lin, Tom K.

AU - Lewis, Michele

AU - Husain, Sohail Z.

AU - Himes, Ryan

AU - Heyman, Melvin B.

AU - Guda, Nalini

AU - Gonska, Tanja

AU - Giefer, Matthew J.

AU - Gelrud, Andres

AU - Gariepy, Cheryl E.

AU - Gardner, Timothy B.

AU - Freedman, Steven D.

AU - Forsmark, Christopher E.

AU - Fishman, Douglas S.

AU - Cote, Gregory A.

AU - Conwell, Darwin

AU - Brand, Randall E.

AU - Bellin, Melena D

AU - Barth, Bradley

AU - Banks, Peter A.

AU - Anderson, Michelle A.

AU - Amann, Stephen T.

AU - Alkaade, Samer

AU - Abu-El-Haija, Maisam

AU - Abberbock, Judah N.

AU - Lowe, Mark E.

AU - Yadav, Dhiraj

PY - 2019/4/1

Y1 - 2019/4/1

N2 - OBJECTIVES: The aim of the present study was to investigate the natural history of chronic pancreatitis (CP); patients in the North American Pancreatitis Study2 (NAPS2, adults) and INternational Study group of Pediatric Pancreatitis: In search for a cuRE (INSPPIRE, pediatric) were compared. 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.

AB - OBJECTIVES: The aim of the present study was to investigate the natural history of chronic pancreatitis (CP); patients in the North American Pancreatitis Study2 (NAPS2, adults) and INternational Study group of Pediatric Pancreatitis: In search for a cuRE (INSPPIRE, pediatric) were compared. 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.

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