Pediatric chronic pancreatitis without prior acute or acute recurrent pancreatitis: A report from the INSPPIRE consortium

Variables Silent CP Traditional CP p-value (n = 20) (n = 185) Family history Acute pancreatitis 4/16 (25%) 45/145 (31%) 0.778 Chronic pancreatitis 5/18 (28%) 49/151 (32%) 1.0 Genetic Risk Factors: PRSS1 9/15 (60%) 66/153 (43%) 0.210 SPINK1 2/14 (14%) 34/136 (25%) 0.520 CFTR 3/14 (21%) 48/147 (33%) 0.551 CTRC 0/7 (0%) 6/95 (6%) 1.0 Obstructive factors 6 (30%) 54/184 (29%) 0.952 Pancreas divisum 2/19 (11%) 23/181 (13%) 1.0 Risk factors Alcoholic 1 (5%) 4/184 (2%) 0.406 Active smoker 1 (5%) 2/184 (1%) 0.267 Passive smoking exposure 3 (15%) 12/179 (7%) 0.180 Hyperlipidemia 0/18 (0%) 5/159 (3%) 1.0 Medications 1/18 (6%) 10/173 (6%) 1.0 Autoimmune pancreatitis 4 (20%) 4/144 (3%) 0.008 Other autoimmune diseases 1/19 (5%) 12/177 (7%) 1.0 Ulcerative colitis 0/19 (0%) 2/177 (1%) 1.0 Indeterminate colitis/IBD-U 0/19 (0%) 1/176 (1%) 1.0 Table 2 Risk factors of CP. Variables Silent CP Traditional CP p-value (n = 20) (n = 185) Imaging studies performed ERCP 14 (70%) 129 (70%) 1.0 Number ERCP (range) (1–7) (1–9) 1 9 67 2 2 31 3 1 13 ≥4 2 18 CT scan 11 (55%) 102 (55%) 0.991 MRI (not performed with MRCP) 3 (15%) 59 (32%) 0.118 MRCP 14 (70%) 155 (84%) 0.130 EUS 4 (20%) 32 (17%) 0.759 Findings (CT/MRI) Focal Acute Pancreatitis 3/15 (20%) 24/153 (16%) 0.712 Inflammatory changes in Pancreas 6/16 (38%) 57/153 (37%) 0.985 Pancreatic Gland Enlargement 2/16 (12%) 25/154 (16%) 1.0 Pancreatic Atrophy Present 10/16 (62%) 67/155 (43%) 0.140 Calcifications in Pancreas present 4/16 (25%) 24/154 (16%) 0.306 Duct Irregularities 11/15 (73%) 89/153 (58%) 0.254 Pancreatic duct dilatation present 11/16 (69%) 93/153 (61%) 0.533 Lesions present in the pancreas 2/16 (12%) 5/158 (3%) 0.127 Gallstones/Sludge 1/15 (7%) 11/156 (7%) 1.0 Intrahepatic biliary dilatation 3/16 (19%) 13/154 (8%) 0.178 Changes suggestive of cirrhosis and/or portal hypertension 1/15 (7%) 9/154 (6%) 1.0 Findings (CT/MRI/MRCP/ERCP) Pancreatic duct obstruction (stricture) 5/19 (26%) 67/175 (38%) 0.305 CBD stricture (Intrapancreatic portion) 3 (15%) 9/177 (5%) 0.109 Dilated CBD 3/19 (16%) 40/178 (22%) 0.770 CBD Stone 2 (10%) 10/178 (6%) 0.347 Findings (CT/MRI/EUS) Peripancreatic inflammation/fat stranding 3/16 (19%) 58/154 (38%) 0.133 Findings (CT/MRI/MRCP/ERCP/EUS) Cysts/Pseudocysts 4 (20%) 41/178 (23%) 1.0 Findings (MRCP/ERCP) Main Pancreatic Duct - Abnormal 15/18 (83%) 135/168 (80%) 1.0 Abnormal Side Branches 8/18 (44%) 77/157 (49%) 0.712 Intraductal filling defects of Calculi 10/18 (56%) 49/161 (30%) 0.032 Pancreas Divisum