title: Natural history of pancreatic involvement in paediatric inflammatory bowel disease.
abstract: BACKGROUND
  Few case reports describe the clinical features of pancreatic involvement in inflammatory bowel disease.
  
  
  OBJECTIVE
  To investigate prevalence and disease course of inflammatory bowel disease children with pancreatitis and with exclusive hyperamylasemia and hyperlipasemia.
  
  
  METHODS
  We used a web-registry to retrospectively identify paediatric inflammatory bowel disease patients with hyperamylasemia and hyperlipasemia. Participants were re-evaluated at 6 months and 1 year.
  
  
  RESULTS
  From a total of 649 paediatric patients, we found 27 with hyperamylasemia and hyperlipasemia (4.1%). Eleven patients (1.6%) fulfilled diagnostic criteria for acute pancreatitis. Female gender was significantly associated with acute pancreatitis (p=0.04). Twenty-five children (92.5%) had colonic disease. At 6 months 1/11 children with acute pancreatitis (9%) showed acute recurrent pancreatitis, while 1 patient (9%) had persistent hyperamylasemia and hyperlipasemia. At 12 months, 1 patient showed chronic pancreatitis (9.1%). Of the 16 children with exclusive hyperamylasemia and hyperlipasemia, 4 developed acute pancreatitis (25%), while 1 patient (6.2%) still presented exclusive hyperamylasemia and hyperlipasemia at 6 months. At 12 months, 11/16 patients (68.7%) reached a remission of pancreatic involvement, whereas 5 remaining patients (32.3%) had persistent hyperamylasemia and hyperlipasemia.
  
  
  CONCLUSIONS
  In inflammatory bowel disease children, acute pancreatitis is more common in colonic disease and in female gender. Pancreatic function should be monitored, considering that pancreatic damage may evolve.
authors.affiliation: Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Martinelli
authors.affiliation: Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Strisciuglio
authors.affiliation: Pediatric Gastroenterology Unit, Spirito Santo Hospital, Pescara, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Illiceto
authors.affiliation: Endoscopy and Gastroenterology Unit, Department of Pediatrics, University of Messina, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Cardile
authors.affiliation: Department of Pediatrics, Unit of Gastroenterology, University Hospital of Padova, Italy.
authors.forename: Graziella
authors.initials: G
authors.lastname: Guariso
authors.affiliation: Gastroenterology and Endoscopy Unit, G. Gaslini Institute for Children, Genoa, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Vignola
authors.affiliation: Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Aloi
authors.affiliation: Division of Pediatrics, General Hospital I.R.C.C.S., S. G. Rotondo (Fg), Italy.
authors.forename: Mario Rocco
authors.initials: MR
authors.lastname: D'Altilia
authors.affiliation: Pediatric Unit, Maggiore Hospital, Bologna, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Alvisi
authors.affiliation: Department of Pediatrics, University of Insubria, Varese, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Salvatore
authors.affiliation: Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Staiano
authors.affiliation: Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cucchiara
authors.affiliation: Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy. Electronic address: erasmo.miele@unina.it.
authors.forename: Erasmo
authors.initials: E
authors.lastname: Miele
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003108:Colonic Diseases / Q000150:complications / Q000201:enzymology*; D005260:Female; D006801:Humans; D034321:Hyperamylasemia / Q000097:blood*; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000201:enzymology* / Q000473:pathology; D008049:Lipase / Q000097:blood*; D008297:Male; D010179:Pancreas / Q000378:metabolism*; D010195:Pancreatitis / Q000201:enzymology*; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D008049:Lipase
keywords: Amylase; Crohn's disease; Lipase; Pancreas; Pancreatitis; Ulcerative colitis