title: Incidence and Clinical Associations of Childhood Acute Pancreatitis.
abstract: To establish the UK incidence and clinical associations of acute pancreatitis (AP) in children aged 0 to 14 years.
  
  
  
  Monthly surveillance of new cases of AP in children under 15 years of age through the British Pediatric Surveillance Unit conducted from April 2013 to April 2014 (inclusive) followed by 1-year administrative follow-up for all valid cases.
  
  
  
  Ninety-four cases (48 boys) fulfilled the diagnostic criteria. The median age at diagnosis was 11.2 years (range 1.3-14.9). White children accounted for 61% of the cases compared with 28% from Asian and 5% from African ethnicities. Pakistani children accounted for 18 of 26 (69%) Asian patients and 19% of the total cohort. The incidence of AP in children in the United Kingdom was 0.78 per 100 000/year (95% confidence interval [CI] 0.62-0.96). The incidence in Pakistani children (4.55; 95% CI 2.60-7.39) was sevenfold greater than white children (0.63; 95% CI 0.47-0.83). Of the 94 cases, 35 (37%) were idiopathic; other associations were: drug therapy, 18 (19%); gallstones, 12 (13%); hereditary, 7 (7%); organic acidemias, 7 (7%); anatomic anomalies, 5 (5%); viral infections, 3 (3%); systemic diseases, 2 (2%); and trauma 1 (1%). The most common drug associations were asparaginase (28%), azathioprine (17%), and sodium valproate (17%).
  
  
  
  Although still relatively uncommon in the United Kingdom, on average there is >1 case of childhood AP diagnosed every week. The associations of AP have changed significantly since the 1970-80s. Overrepresentation of Pakistani children is worthy of further investigation.
authors.affiliation: National Institute for Health Research, Bristol Biomedical Research Unit in Nutrition and University of Bristol, United Kingdom; Bristol Royal Hospital for Children, Bristol, United Kingdom; a.a.majbar@bristol.ac.uk.
authors.forename: Abdalmonem A
authors.initials: AA
authors.lastname: Majbar
authors.affiliation: Bristol Royal Hospital for Children, Bristol, United Kingdom;
authors.forename: Eleri
authors.initials: E
authors.lastname: Cusick
authors.affiliation: Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom; and.
authors.forename: Paul
authors.initials: P
authors.lastname: Johnson
authors.affiliation: British Paediatric Surveillance Unit, Royal College of Paediatrics and Child Health, London, United Kingdom.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Lynn
authors.affiliation: Musculoskeletal Research Unit, University of Bristol, United Kingdom;
authors.forename: Linda P
authors.initials: LP
authors.lastname: Hunt
authors.affiliation: National Institute for Health Research, Bristol Biomedical Research Unit in Nutrition and University of Bristol, United Kingdom; Bristol Royal Hospital for Children, Bristol, United Kingdom;
authors.forename: Julian P H
authors.initials: JP
authors.lastname: Shield
mesh_terms: D000138:Acidosis / Q000150:complications / Q000453:epidemiology; D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000453:epidemiology; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000150:complications / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010195:Pancreatitis / Q000453:epidemiology* / Q000209:etiology; D011159:Population Surveillance; D011446:Prospective Studies; D044469:Racial Groups / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology; D014777:Virus Diseases / Q000150:complications / Q000453:epidemiology