A Better Understanding of Pediatric Autoimmune Pancreatitis: Over 13 Years of Experience
Por:
Diana Garcia Tirado, Molera C, Álvarez Beltrán M, Mercadal-Hally M, Vaquero Raya EC, Meavilla-Olivas SM, Johanna Martínez Osorio, Barber-Martínez de la Torre I, Cárdenas Vásquez A, Segarra Canton O and Martín-de-Carpi J
Publicada:
1 may 2023
Ahead of Print:
9 feb 2023
Resumen:
Objectives: Pediatric autoimmune pancreatitis (P-AIP) is an uncommon disease whose diagnosis requires strong clinical suspicion. Late diagno-sis increases morbidity. We aimed to compare the usefulness of the 2011 International Consensus Diagnostic Criteria (ICDC) for Autoimmune Pan-creatitis with the 2018 INSPPIRE (INternational Study Group of Pediatric Pancreatitis: In search for a cuRE) criteria.Methods: We retrospectively analyzed demographics and clinical, labora-tory, radiological, and histological findings at diagnosis and during long-term follow-up in children diagnosed with AIP in 2 tertiary hospitals between 2008 and 2021.Results: We included 11 patients [6 girls; median age at diagnosis, 12.5 (range 2.8-15.7) years]. The most common symptom was abdominal pain. Pancreatic enzymes were elevated in 10 patients, and serum immunoglobu-lin G4 was elevated in 1 . Magnetic resonance imaging showed enlargement of the pancreatic head in 10 patients and general pancreatic enlargement in 1. Pancreatic and papilla tissue were obtained from 9 patients. All patients received corticosteroids (prednisolone), and 4 also received azathioprine.According to the ICDC, all patients were classified as probable or non-otherwise specified AIP. According to INSPPIRE criteria, all patients were classified as AIP. Using the INSPPIRE criteria would have avoided biopsies in 6 patients who responded well to corticosteroids.Conclusions: The INSPPIRE criteria are useful. Using the ICDC in pedi-atric patients can delay diagnosis and result in unnecessary invasive tests.
Filiaciones:
Diana Garcia Tirado:
Pediatric Gastroenterology, Hepatology and Nutrition Department. Sant Joan de Déu Hospital. Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain. (+34) 932 53 21 00.
Álvarez Beltrán M:
Pediatric Gastroenterology and Nutritional Unit, Pediatric Service, Vall d'Hebron University Hospital. Passeig de la Vall d'Hebron, 119, 08035 Barcelona, Spain. (+34) 934 89 30 00.
Mercadal-Hally M:
Pediatric Hepatology and Liver Transplantation Unit, Pediatric Service, Vall d´Hebron University Hospital. Passeig de la Vall d'Hebron, 119, 08035 Barcelona, Spain. (+34) 934 89 30 00.
Vaquero Raya EC:
Institute of Digestive and Metabolic Diseases (ICMDM), Clínic Hospital, Carrer de Villarroel, 170, 08036 Barcelona, Spain. (+34) 932 27 54 00.
Barber-Martínez de la Torre I:
Pediatric Gastroenterology, Hepatology and Nutrition Department. Sant Joan de Déu Hospital. Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain. (+34) 932 53 21 00.
Cárdenas Vásquez A:
Head of the Pediatric Radiology Service. Sant Joan de Déu Hopsital. Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain. (+34) 932 53 21 00.
Segarra Canton O:
Institute of Digestive and Metabolic Diseases (ICMDM), Clínic Hospital. Carrer de Villarroel, 170, 08036 Barcelona, Spain. (+34) 932 27 54 00.
Martín-de-Carpi J:
Head of the Pediatric Gastroenterology, Hepatology and Nutrition Department. Sant Joan de Déu Hospital. Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain. (+34) 932 53 21 00.
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