title: Novel characterization of drug-associated pancreatitis in children.
abstract: OBJECTIVE
  Medications are a major cause of acute pancreatitis; however, little is known about their influence in children. Our primary aims were to identify common comorbidities and concomitant pancreatitis etiologies in children with drug-associated pancreatitis. Our secondary aims were to identify the most commonly associated drugs in the different age groups, evaluate management practices, and compare drug-associated cases with non-drug-associated cases.
  
  
  METHODS
  In the present study, we examined children (ages 0-20 years) admitted to Yale-New Haven Children's Hospital with pancreatitis between 1994 and 2007.
  
  
  RESULTS
  Of a total of 271 pediatric cases, drugs were associated with pancreatitis in 25.6% (55). The 3 most common comorbidities in children with drug-associated pancreatitis were seizure disorders, acute lymphocytic leukemia, and Crohn disease. One third of drug-associated cases had an additional pancreatitis etiology. The most commonly associated drugs were valproic acid and corticosteroids. Compared with non-drug-associated cases, children with drug-associated cases were more likely to undergo CT scanning (54.5% vs 28.4%; P < 0.001), stay in the hospital longer (10 vs 4 days; P < 0.001), and transition to parenteral nutrition from a nil per os status (37.5% vs 21.2%; P < 0.05). There was a higher frequency of valproic acid-associated cases in children younger than 11 years (29.4% vs 9.5% in the 11- to 20-year-old age group).
  
  
  CONCLUSIONS
  Our study underscores the importance of considering drugs as a cause and a contributor to pancreatitis in children, particularly valproic acid in young children.
authors.affiliation: Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520, USA.
authors.forename: Harrison X
authors.initials: HX
authors.lastname: Bai
authors.forename: Michael H
authors.initials: MH
authors.lastname: Ma
authors.forename: Abrahim I
authors.initials: AI
authors.lastname: Orabi
authors.forename: Alexander
authors.initials: A
authors.lastname: Park
authors.forename: Sahibzada U
authors.initials: SU
authors.lastname: Latif
authors.forename: Vineet
authors.initials: V
authors.lastname: Bhandari
authors.forename: Sohail Z
authors.initials: SZ
authors.lastname: Husain
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003424:Crohn Disease / Q000453:epidemiology*; D004827:Epilepsy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007945:Leukemia, Lymphoid / Q000453:epidemiology*; D008297:Male; D010195:Pancreatitis / Q000139:chemically induced* / Q000453:epidemiology*; D010288:Parenteral Nutrition; D012189:Retrospective Studies; D014635:Valproic Acid / Q000494:pharmacology; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D014635:Valproic Acid