Incidence, prevalence, etiology, and prognosis of first-time chronic pancreatitis in young patients: a nationwide cohort study.
OBJECTIVE
Publications on etiology of chronic pancreatitis (CP) are infrequent. Etiologies today encompass genetic disorders. We wanted to describe etiologies of today and identify patients with genetic disorders like hereditary pancreatitis (HP), mutations in Serine Protease Inhibitor Kazal type1 (SPINK1), and the Cystic Fibrosis Transmembrane Conductance Regulator gene (CFTR) among patients formerly considered to have idiopathic CP.


METHODS
Data on patients diagnosed with first-time CP < 30 years of age in Denmark identified in the Danish National Registry of Patients were retrieved. Patients previously considered to have idiopathic pancreatitis were offered genetic counseling and evaluation for HP, SPINK1, and CFTR mutations.


RESULTS
In the period 1980-2004, 580 patients < 30 years of age presented with CP, the standardized prevalence ratio of CP increased from 11.7 per 100,000 person years in 1980-1984 to 17.0 per 100,000 in 2000-2004 (p < 0.001). The odds ratio (OR) having gallstone-related CP increased in the latter time period, especially in women, that of alcohol-induced CP decreased over time. OR having idiopathic CP increased in the latter period; 50% of patients with idiopathic pancreatitis accepted genetic reevaluation; 28 patients had a genetic mutation that totally or partly could explain their pancreatitis, nine of these had two, and 11 patients had HP.


CONCLUSIONS
The prevalence of CP, especially in women, increased over time. Genetic causes that partly or totally could explain the CP were found in 54.90% (95% CI (40.45-68.62)) of those with idiopathic CP, as a minimum estimation 1.9% (95% CI (1.00-3.47)) of the total cohort had HP.
Joergensen
Maiken
M
Department of Medical Gastroenterology S, Odense University Hospital, University of Southern Denmark, Sdr. Boulevard 29, 5000, Odense C, Denmark, maiken.t.joergensen@ouh.regionsyddanmark.dk.
Brusgaard
Klaus
K
Crüger
Dorthe Gylling
DG
Gerdes
Anne-Marie
AM
de Muckadell
Ove B Schaffalitzky
OB
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002423:Cause of Death; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D010188:Exocrine Pancreatic Insufficiency / Q000209:etiology* / Q000401:mortality*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D019512:Pancreatitis, Alcoholic / Q000209:etiology / Q000401:mortality; D050500:Pancreatitis, Chronic / Q000209:etiology* / Q000401:mortality*; D015995:Prevalence; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data*; D017678:Sex Distribution; D055815:Young Adult