Genetic and Electrophysiological Characteristics of Recurrent Acute Pancreatitis
ABSTRACT Objectives: The aim was to present the workup of patients with acute recurrent pancreatitis (ARP) for genetic analysis and electrophysiological testing. Methods: Patients with ARP with unknown etiology were referred for genetic testing and evaluation of cystic fibrosis transmembrane conduct...
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| Veröffentlicht in: | Journal of pediatric gastroenterology and nutrition 2015-05, Vol.60 (5), p.675-679 |
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| creator | Werlin, Steven Konikoff, Fred M. Halpern, Zamir Barkay, Olga Yerushalmi, Baruch Broide, Efrat Santo, Erwin Shamir, Raanan Shaoul, Ron Shteyer, Eyal Yaakov, Yasmin Cohen, Michael Kerem, Eitan Ruszniewski, Philippe Masson, Emmanuelle Ferec, Claude Wilschanski, Michael |
| description | ABSTRACT
Objectives:
The aim was to present the workup of patients with acute recurrent pancreatitis (ARP) for genetic analysis and electrophysiological testing.
Methods:
Patients with ARP with unknown etiology were referred for genetic testing and evaluation of cystic fibrosis transmembrane conductor regulator (CFTR) function by nasal potential difference (NPD) testing.
Results:
A total of 67 patients were evaluated. The mean age was 23 ± 17 years (median 17.0 years, range 1.5–72 years); 90% were Jewish and 10% Arab. Ten (15%) patients carried PRSS1 gene mutation (K23R(7), R122H(2), and D21A(1)). One patient had K172E/− (chymotrypsin C [CTRC]) mutation, 1 had I42M (serine protease inhibitor Kazal type 1 [SPINK1])/V235I (CTRC) together with ΔF508/5T, 1 patient had R67H (SPINK1)/V235I (CTRC), and 1 patient had V235I (CTRC)/−. Ten of 67 (15%) patients submitted for CFTR gene testing carried mutations (ΔF508/L997F, ΔF508/5T(11TG), W1282/5T(12TG), W1282X/Y1014C, ΔF508/R31C, R117H/−, R117H/Y1014C, D1152H/−, 5T(11TG)/−, and L997F/−). Fifty‐four (80%) patients underwent sweat testing. Of these, 5 had sweat chloride ≥60 mEq/L, and 22 patients had sweat chloride from 40 to 60 mEq/L. Of the 56 (83%) patients had nasal potential difference testing, 4 (6%) with abnormal results.
Conclusions:
One‐third (34%) of patients with ARP carry mutations for hereditary pancreatitis including rare mutations (K23R), and 12.5% have evidence of cftr mutations and 10% had CFTR dysfunction underscoring the importance of genetic and functional workup of these patients. |
| doi_str_mv | 10.1097/MPG.0000000000000623 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1675875306</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1675875306</sourcerecordid><originalsourceid>FETCH-LOGICAL-c6623-49fcca3886180bbc53f8b203e760e3a87a5188098763687eeff05f8b6eea03933</originalsourceid><addsrcrecordid>eNqNkE1PAjEQhhujUfz4B8bs0ctiu6Ufe_CABFCDSoyem1JnpVp2se3G8O-tAY3xonOZy_O-M3kQOia4S3Apzm6m4y7-ObygW6hDGOV5T2KyjTq4ECIvCOF7aD-El8SIHsO7aK9gVFIhWQdNx1BDtCbT9VM2dGCib5bzVbCNa56t0S4bzLXXJoK3IXEha6rsHkzrPdQx65s2QjbVtfGgo402HKKdSrsAR5t9gB5Hw4fBZT65G18N-pPc8PRo3isrYzSVkhOJZzPDaCVnBaYgOAaqpdCMSIlLKTjlUgBUFWYJ4QAa05LSA3S67l365q2FENXCBgPO6RqaNijCBZOCUcwT2lujxjcheKjU0tuF9itFsPp0qZJL9dtlip1sLrSzBTx9h77kJUCugffGJT_h1bXv4NUctIvzv7rPN1HrYPWvf9T19JZejLAoWEk_AMbzkYg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1675875306</pqid></control><display><type>article</type><title>Genetic and Electrophysiological Characteristics of Recurrent Acute Pancreatitis</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Journals@Ovid Complete</source><creator>Werlin, Steven ; Konikoff, Fred M. ; Halpern, Zamir ; Barkay, Olga ; Yerushalmi, Baruch ; Broide, Efrat ; Santo, Erwin ; Shamir, Raanan ; Shaoul, Ron ; Shteyer, Eyal ; Yaakov, Yasmin ; Cohen, Michael ; Kerem, Eitan ; Ruszniewski, Philippe ; Masson, Emmanuelle ; Ferec, Claude ; Wilschanski, Michael</creator><creatorcontrib>Werlin, Steven ; Konikoff, Fred M. ; Halpern, Zamir ; Barkay, Olga ; Yerushalmi, Baruch ; Broide, Efrat ; Santo, Erwin ; Shamir, Raanan ; Shaoul, Ron ; Shteyer, Eyal ; Yaakov, Yasmin ; Cohen, Michael ; Kerem, Eitan ; Ruszniewski, Philippe ; Masson, Emmanuelle ; Ferec, Claude ; Wilschanski, Michael</creatorcontrib><description>ABSTRACT
Objectives:
The aim was to present the workup of patients with acute recurrent pancreatitis (ARP) for genetic analysis and electrophysiological testing.
Methods:
Patients with ARP with unknown etiology were referred for genetic testing and evaluation of cystic fibrosis transmembrane conductor regulator (CFTR) function by nasal potential difference (NPD) testing.
Results:
A total of 67 patients were evaluated. The mean age was 23 ± 17 years (median 17.0 years, range 1.5–72 years); 90% were Jewish and 10% Arab. Ten (15%) patients carried PRSS1 gene mutation (K23R(7), R122H(2), and D21A(1)). One patient had K172E/− (chymotrypsin C [CTRC]) mutation, 1 had I42M (serine protease inhibitor Kazal type 1 [SPINK1])/V235I (CTRC) together with ΔF508/5T, 1 patient had R67H (SPINK1)/V235I (CTRC), and 1 patient had V235I (CTRC)/−. Ten of 67 (15%) patients submitted for CFTR gene testing carried mutations (ΔF508/L997F, ΔF508/5T(11TG), W1282/5T(12TG), W1282X/Y1014C, ΔF508/R31C, R117H/−, R117H/Y1014C, D1152H/−, 5T(11TG)/−, and L997F/−). Fifty‐four (80%) patients underwent sweat testing. Of these, 5 had sweat chloride ≥60 mEq/L, and 22 patients had sweat chloride from 40 to 60 mEq/L. Of the 56 (83%) patients had nasal potential difference testing, 4 (6%) with abnormal results.
Conclusions:
One‐third (34%) of patients with ARP carry mutations for hereditary pancreatitis including rare mutations (K23R), and 12.5% have evidence of cftr mutations and 10% had CFTR dysfunction underscoring the importance of genetic and functional workup of these patients.</description><identifier>ISSN: 0277-2116</identifier><identifier>EISSN: 1536-4801</identifier><identifier>DOI: 10.1097/MPG.0000000000000623</identifier><identifier>PMID: 25383785</identifier><language>eng</language><publisher>United States: by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology</publisher><subject>Acute Disease ; acute recurrent pancreatitis ; Adolescent ; Adult ; Aged ; Arabs - genetics ; Carrier Proteins - genetics ; cftr ; Child ; Child, Preschool ; Chlorides - analysis ; Chymotrypsin - genetics ; Cystic Fibrosis Transmembrane Conductance Regulator - genetics ; Cystic Fibrosis Transmembrane Conductance Regulator - metabolism ; Electrophysiological Phenomena ; Female ; Humans ; Infant ; Israel ; Jews - genetics ; Male ; Membrane Potentials ; Middle Aged ; nasal potential difference ; Nose - physiopathology ; Pancreatitis - ethnology ; Pancreatitis - genetics ; Pancreatitis - physiopathology ; Recurrence ; Respiratory Mucosa - physiopathology ; Sweat - chemistry ; Trypsin - genetics ; Trypsin Inhibitor, Kazal Pancreatic ; Young Adult</subject><ispartof>Journal of pediatric gastroenterology and nutrition, 2015-05, Vol.60 (5), p.675-679</ispartof><rights>2015 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition</rights><rights>2015 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6623-49fcca3886180bbc53f8b203e760e3a87a5188098763687eeff05f8b6eea03933</citedby><cites>FETCH-LOGICAL-c6623-49fcca3886180bbc53f8b203e760e3a87a5188098763687eeff05f8b6eea03933</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1097%2FMPG.0000000000000623$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1097%2FMPG.0000000000000623$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25383785$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Werlin, Steven</creatorcontrib><creatorcontrib>Konikoff, Fred M.</creatorcontrib><creatorcontrib>Halpern, Zamir</creatorcontrib><creatorcontrib>Barkay, Olga</creatorcontrib><creatorcontrib>Yerushalmi, Baruch</creatorcontrib><creatorcontrib>Broide, Efrat</creatorcontrib><creatorcontrib>Santo, Erwin</creatorcontrib><creatorcontrib>Shamir, Raanan</creatorcontrib><creatorcontrib>Shaoul, Ron</creatorcontrib><creatorcontrib>Shteyer, Eyal</creatorcontrib><creatorcontrib>Yaakov, Yasmin</creatorcontrib><creatorcontrib>Cohen, Michael</creatorcontrib><creatorcontrib>Kerem, Eitan</creatorcontrib><creatorcontrib>Ruszniewski, Philippe</creatorcontrib><creatorcontrib>Masson, Emmanuelle</creatorcontrib><creatorcontrib>Ferec, Claude</creatorcontrib><creatorcontrib>Wilschanski, Michael</creatorcontrib><title>Genetic and Electrophysiological Characteristics of Recurrent Acute Pancreatitis</title><title>Journal of pediatric gastroenterology and nutrition</title><addtitle>J Pediatr Gastroenterol Nutr</addtitle><description>ABSTRACT
Objectives:
The aim was to present the workup of patients with acute recurrent pancreatitis (ARP) for genetic analysis and electrophysiological testing.
Methods:
Patients with ARP with unknown etiology were referred for genetic testing and evaluation of cystic fibrosis transmembrane conductor regulator (CFTR) function by nasal potential difference (NPD) testing.
Results:
A total of 67 patients were evaluated. The mean age was 23 ± 17 years (median 17.0 years, range 1.5–72 years); 90% were Jewish and 10% Arab. Ten (15%) patients carried PRSS1 gene mutation (K23R(7), R122H(2), and D21A(1)). One patient had K172E/− (chymotrypsin C [CTRC]) mutation, 1 had I42M (serine protease inhibitor Kazal type 1 [SPINK1])/V235I (CTRC) together with ΔF508/5T, 1 patient had R67H (SPINK1)/V235I (CTRC), and 1 patient had V235I (CTRC)/−. Ten of 67 (15%) patients submitted for CFTR gene testing carried mutations (ΔF508/L997F, ΔF508/5T(11TG), W1282/5T(12TG), W1282X/Y1014C, ΔF508/R31C, R117H/−, R117H/Y1014C, D1152H/−, 5T(11TG)/−, and L997F/−). Fifty‐four (80%) patients underwent sweat testing. Of these, 5 had sweat chloride ≥60 mEq/L, and 22 patients had sweat chloride from 40 to 60 mEq/L. Of the 56 (83%) patients had nasal potential difference testing, 4 (6%) with abnormal results.
Conclusions:
One‐third (34%) of patients with ARP carry mutations for hereditary pancreatitis including rare mutations (K23R), and 12.5% have evidence of cftr mutations and 10% had CFTR dysfunction underscoring the importance of genetic and functional workup of these patients.</description><subject>Acute Disease</subject><subject>acute recurrent pancreatitis</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Arabs - genetics</subject><subject>Carrier Proteins - genetics</subject><subject>cftr</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Chlorides - analysis</subject><subject>Chymotrypsin - genetics</subject><subject>Cystic Fibrosis Transmembrane Conductance Regulator - genetics</subject><subject>Cystic Fibrosis Transmembrane Conductance Regulator - metabolism</subject><subject>Electrophysiological Phenomena</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Israel</subject><subject>Jews - genetics</subject><subject>Male</subject><subject>Membrane Potentials</subject><subject>Middle Aged</subject><subject>nasal potential difference</subject><subject>Nose - physiopathology</subject><subject>Pancreatitis - ethnology</subject><subject>Pancreatitis - genetics</subject><subject>Pancreatitis - physiopathology</subject><subject>Recurrence</subject><subject>Respiratory Mucosa - physiopathology</subject><subject>Sweat - chemistry</subject><subject>Trypsin - genetics</subject><subject>Trypsin Inhibitor, Kazal Pancreatic</subject><subject>Young Adult</subject><issn>0277-2116</issn><issn>1536-4801</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1PAjEQhhujUfz4B8bs0ctiu6Ufe_CABFCDSoyem1JnpVp2se3G8O-tAY3xonOZy_O-M3kQOia4S3Apzm6m4y7-ObygW6hDGOV5T2KyjTq4ECIvCOF7aD-El8SIHsO7aK9gVFIhWQdNx1BDtCbT9VM2dGCib5bzVbCNa56t0S4bzLXXJoK3IXEha6rsHkzrPdQx65s2QjbVtfGgo402HKKdSrsAR5t9gB5Hw4fBZT65G18N-pPc8PRo3isrYzSVkhOJZzPDaCVnBaYgOAaqpdCMSIlLKTjlUgBUFWYJ4QAa05LSA3S67l365q2FENXCBgPO6RqaNijCBZOCUcwT2lujxjcheKjU0tuF9itFsPp0qZJL9dtlip1sLrSzBTx9h77kJUCugffGJT_h1bXv4NUctIvzv7rPN1HrYPWvf9T19JZejLAoWEk_AMbzkYg</recordid><startdate>201505</startdate><enddate>201505</enddate><creator>Werlin, Steven</creator><creator>Konikoff, Fred M.</creator><creator>Halpern, Zamir</creator><creator>Barkay, Olga</creator><creator>Yerushalmi, Baruch</creator><creator>Broide, Efrat</creator><creator>Santo, Erwin</creator><creator>Shamir, Raanan</creator><creator>Shaoul, Ron</creator><creator>Shteyer, Eyal</creator><creator>Yaakov, Yasmin</creator><creator>Cohen, Michael</creator><creator>Kerem, Eitan</creator><creator>Ruszniewski, Philippe</creator><creator>Masson, Emmanuelle</creator><creator>Ferec, Claude</creator><creator>Wilschanski, Michael</creator><general>by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201505</creationdate><title>Genetic and Electrophysiological Characteristics of Recurrent Acute Pancreatitis</title><author>Werlin, Steven ; Konikoff, Fred M. ; Halpern, Zamir ; Barkay, Olga ; Yerushalmi, Baruch ; Broide, Efrat ; Santo, Erwin ; Shamir, Raanan ; Shaoul, Ron ; Shteyer, Eyal ; Yaakov, Yasmin ; Cohen, Michael ; Kerem, Eitan ; Ruszniewski, Philippe ; Masson, Emmanuelle ; Ferec, Claude ; Wilschanski, Michael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6623-49fcca3886180bbc53f8b203e760e3a87a5188098763687eeff05f8b6eea03933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acute Disease</topic><topic>acute recurrent pancreatitis</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Arabs - genetics</topic><topic>Carrier Proteins - genetics</topic><topic>cftr</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Chlorides - analysis</topic><topic>Chymotrypsin - genetics</topic><topic>Cystic Fibrosis Transmembrane Conductance Regulator - genetics</topic><topic>Cystic Fibrosis Transmembrane Conductance Regulator - metabolism</topic><topic>Electrophysiological Phenomena</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Israel</topic><topic>Jews - genetics</topic><topic>Male</topic><topic>Membrane Potentials</topic><topic>Middle Aged</topic><topic>nasal potential difference</topic><topic>Nose - physiopathology</topic><topic>Pancreatitis - ethnology</topic><topic>Pancreatitis - genetics</topic><topic>Pancreatitis - physiopathology</topic><topic>Recurrence</topic><topic>Respiratory Mucosa - physiopathology</topic><topic>Sweat - chemistry</topic><topic>Trypsin - genetics</topic><topic>Trypsin Inhibitor, Kazal Pancreatic</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Werlin, Steven</creatorcontrib><creatorcontrib>Konikoff, Fred M.</creatorcontrib><creatorcontrib>Halpern, Zamir</creatorcontrib><creatorcontrib>Barkay, Olga</creatorcontrib><creatorcontrib>Yerushalmi, Baruch</creatorcontrib><creatorcontrib>Broide, Efrat</creatorcontrib><creatorcontrib>Santo, Erwin</creatorcontrib><creatorcontrib>Shamir, Raanan</creatorcontrib><creatorcontrib>Shaoul, Ron</creatorcontrib><creatorcontrib>Shteyer, Eyal</creatorcontrib><creatorcontrib>Yaakov, Yasmin</creatorcontrib><creatorcontrib>Cohen, Michael</creatorcontrib><creatorcontrib>Kerem, Eitan</creatorcontrib><creatorcontrib>Ruszniewski, Philippe</creatorcontrib><creatorcontrib>Masson, Emmanuelle</creatorcontrib><creatorcontrib>Ferec, Claude</creatorcontrib><creatorcontrib>Wilschanski, Michael</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric gastroenterology and nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Werlin, Steven</au><au>Konikoff, Fred M.</au><au>Halpern, Zamir</au><au>Barkay, Olga</au><au>Yerushalmi, Baruch</au><au>Broide, Efrat</au><au>Santo, Erwin</au><au>Shamir, Raanan</au><au>Shaoul, Ron</au><au>Shteyer, Eyal</au><au>Yaakov, Yasmin</au><au>Cohen, Michael</au><au>Kerem, Eitan</au><au>Ruszniewski, Philippe</au><au>Masson, Emmanuelle</au><au>Ferec, Claude</au><au>Wilschanski, Michael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Genetic and Electrophysiological Characteristics of Recurrent Acute Pancreatitis</atitle><jtitle>Journal of pediatric gastroenterology and nutrition</jtitle><addtitle>J Pediatr Gastroenterol Nutr</addtitle><date>2015-05</date><risdate>2015</risdate><volume>60</volume><issue>5</issue><spage>675</spage><epage>679</epage><pages>675-679</pages><issn>0277-2116</issn><eissn>1536-4801</eissn><abstract>ABSTRACT
Objectives:
The aim was to present the workup of patients with acute recurrent pancreatitis (ARP) for genetic analysis and electrophysiological testing.
Methods:
Patients with ARP with unknown etiology were referred for genetic testing and evaluation of cystic fibrosis transmembrane conductor regulator (CFTR) function by nasal potential difference (NPD) testing.
Results:
A total of 67 patients were evaluated. The mean age was 23 ± 17 years (median 17.0 years, range 1.5–72 years); 90% were Jewish and 10% Arab. Ten (15%) patients carried PRSS1 gene mutation (K23R(7), R122H(2), and D21A(1)). One patient had K172E/− (chymotrypsin C [CTRC]) mutation, 1 had I42M (serine protease inhibitor Kazal type 1 [SPINK1])/V235I (CTRC) together with ΔF508/5T, 1 patient had R67H (SPINK1)/V235I (CTRC), and 1 patient had V235I (CTRC)/−. Ten of 67 (15%) patients submitted for CFTR gene testing carried mutations (ΔF508/L997F, ΔF508/5T(11TG), W1282/5T(12TG), W1282X/Y1014C, ΔF508/R31C, R117H/−, R117H/Y1014C, D1152H/−, 5T(11TG)/−, and L997F/−). Fifty‐four (80%) patients underwent sweat testing. Of these, 5 had sweat chloride ≥60 mEq/L, and 22 patients had sweat chloride from 40 to 60 mEq/L. Of the 56 (83%) patients had nasal potential difference testing, 4 (6%) with abnormal results.
Conclusions:
One‐third (34%) of patients with ARP carry mutations for hereditary pancreatitis including rare mutations (K23R), and 12.5% have evidence of cftr mutations and 10% had CFTR dysfunction underscoring the importance of genetic and functional workup of these patients.</abstract><cop>United States</cop><pub>by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology</pub><pmid>25383785</pmid><doi>10.1097/MPG.0000000000000623</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Journals@Ovid Complete |
| subjects | Acute Disease acute recurrent pancreatitis Adolescent Adult Aged Arabs - genetics Carrier Proteins - genetics cftr Child Child, Preschool Chlorides - analysis Chymotrypsin - genetics Cystic Fibrosis Transmembrane Conductance Regulator - genetics Cystic Fibrosis Transmembrane Conductance Regulator - metabolism Electrophysiological Phenomena Female Humans Infant Israel Jews - genetics Male Membrane Potentials Middle Aged nasal potential difference Nose - physiopathology Pancreatitis - ethnology Pancreatitis - genetics Pancreatitis - physiopathology Recurrence Respiratory Mucosa - physiopathology Sweat - chemistry Trypsin - genetics Trypsin Inhibitor, Kazal Pancreatic Young Adult |
| title | Genetic and Electrophysiological Characteristics of Recurrent Acute Pancreatitis |
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