title: Definitions of pediatric pancreatitis and survey of present clinical practices.
abstract: OBJECTIVE
  There is limited literature on acute pancreatitis (AP), acute recurrent pancreatitis (ARP), and chronic pancreatitis (CP) in children. The International Study Group of Pediatric Pancreatitis: In Search for a Cure (INSPPIRE) consortium was formed to standardize definitions, develop diagnostic algorithms, investigate disease pathophysiology, and design prospective multicenter studies in pediatric pancreatitis.
  
  
  METHODS
  Subcommittees were formed to delineate definitions of pancreatitis, and a survey was conducted to analyze present practice.
  
  
  RESULTS
  AP was defined as requiring 2 of the following: abdominal pain compatible with AP, serum amylase and/or lipase values ≥3 times upper limits of normal, and imaging findings of AP. ARP was defined as ≥2 distinct episodes of AP with intervening return to baseline. CP was diagnosed in the presence of typical abdominal pain plus characteristic imaging findings, or exocrine insufficiency plus imaging findings, or endocrine insufficiency plus imaging findings. We found that children with pancreatitis were primarily managed by pediatric gastroenterologists. Unless the etiology was known, initial investigations included serum liver enzymes, triglycerides, calcium, and abdominal ultrasound. Further investigations (usually for ARP and CP) included magnetic resonance or other imaging, sweat chloride, and genetic testing. Respondents' future goals for INSPPIRE included determining natural history of pancreatitis, developing algorithms to evaluate and manage pancreatitis, and validating diagnostic criteria.
  
  
  CONCLUSIONS
  INSPPIRE represents the first initiative to create a multicenter approach to systematically characterize pancreatitis in children. Future aims include creation of patient database and biologic sample repository.
authors.affiliation: Division of Pediatric Gastroenterology and Nutrition, Montreal Children's Hospital, McGill University, Canada.
authors.forename: Veronique D
authors.initials: VD
authors.lastname: Morinville
authors.forename: Sohail Z
authors.initials: SZ
authors.lastname: Husain
authors.forename: Harrison
authors.initials: H
authors.lastname: Bai
authors.forename: Bradley
authors.initials: B
authors.lastname: Barth
authors.forename: Rabea
authors.initials: R
authors.lastname: Alhosh
authors.forename: Peter R
authors.initials: PR
authors.lastname: Durie
authors.forename: Steven D
authors.initials: SD
authors.lastname: Freedman
authors.forename: Ryan
authors.initials: R
authors.lastname: Himes
authors.forename: Mark E
authors.initials: ME
authors.lastname: Lowe
authors.forename: John
authors.initials: J
authors.lastname: Pohl
authors.forename: Steven
authors.initials: S
authors.lastname: Werlin
authors.forename: Michael
authors.initials: M
authors.lastname: Wilschanski
authors.forename: Aliye
authors.initials: A
authors.lastname: Uc
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000208:Acute Disease; D000681:Amylases / Q000097:blood*; D002648:Child; D002908:Chronic Disease; D003952:Diagnostic Imaging; D019468:Disease Management; D019538:Health Care Surveys; D006801:Humans; D008049:Lipase / Q000097:blood*; D010195:Pancreatitis / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D050500:Pancreatitis, Chronic / Q000097:blood / Q000150:complications / Q000175:diagnosis*
chemical_list: D008049:Lipase; D000681:Amylases