Acute recurrent pancreatitis is defined as having more than 1 attack, typically separated by a 1 month free interval, but could be less than 1 month if there is normalization of enzymes and a pain-free period.
Chronic pancreatitis requires imaging findings plus one of three: abdominal pain consistent with pancreatic origin, evidence of exocrine insufficiency, or endocrine insufficiency.
Acute pancreatitis is diagnosed when the patient has 2 out of 3 criteria: classic epigastric pain, lipase or amylase 3 times the upper limit of normal, and imaging findings.
In the International Study Group cohort of 300 pediatric pancreatitis patients, genetic causes were positive in 48% of acute recurrent pancreatitis patients and 33% of chronic pancreatitis patients when searching for one of 4 genes.
quoteWe are thrilled, excited to be with you today. While we give you updates, we will be going through your questions live that you send through the talk.↗
▶Ep 7 · 5:15
guidelineAcute pancreatitis is diagnosed when the patient has 2 out of 3 criteria: classic epigastric pain, lipase or amylase 3 times the upper limit of normal, and imaging findings.↗
▶Ep 7 · 5:30
guidelineAcute recurrent pancreatitis is defined as having more than 1 attack, typically separated by a 1 month free interval, but could be less than 1 month if there is normalization of enzymes and a pain-free period.↗
▶Ep 7 · 6:00
guidelineChronic pancreatitis requires imaging findings plus one of three: abdominal pain consistent with pancreatic origin, evidence of exocrine insufficiency, or endocrine insufficiency.↗
▶Ep 7 · 6:35
epidemiologicalNew cases of acute pancreatitis have an incidence in the United States of 1 in 10,000 cases, with up to a third developing recurrent attacks.↗
▶Ep 7 · 6:45
epidemiologicalChronic pancreatitis in the young population has an incidence of up to 2 per 100,000.↗
▶Ep 7 · 6:45
quoteFor us to advance the field further, we really need biomarkers for early disease.↗
▶Ep 7 · 14:20
epidemiologicalIn the International Study Group cohort of 300 pediatric pancreatitis patients, genetic causes were positive in 48% of acute recurrent pancreatitis patients and 33% of chronic pancreatitis patients when searching for one of 4 genes.↗
▶Ep 7 · 15:50
clinicalThe Cincinnati Children's 10-gene pancreatic genetic testing panel uses next generation sequencing with more than 50x coverage at every targeted base, with all pathogenic and novel variants confirmed by Sanger sequencing.↗
▶Ep 7 · 16:15
opinionVariants of unknown clinical significance are reported because what is a variant of unknown significance today might be reclassified as pathogenic or likely pathogenic later as more studies are done.↗
▶Ep 7 · 18:20
quoteWhy would a patient who does not smoke or drink alcohol in pediatric have pancreatitis, and she did not have anatomic abnormalities or any of the list of causes that I showed you.↗
▶Ep 7 · 20:40
quoteThis genetic testing was life changing, not just for the patient, but for her family as well.↗
▶Ep 7 · 22:00
clinicalGenetic testing should ideally be ordered as directed by a genetic counselor after discussing implications for the patient's future, medical insurance, offspring, and family members.↗
▶Ep 7 · 22:20
quoteIf the genetic counselor is not ordering the test, some, um, institutions cannot be reimbursed for it.↗
▶Ep 7 · 32:30
epidemiologicalIn a cross-sectional analysis of 52 chronic pancreatitis patients at Cincinnati Children's, 25% were diagnosed with either pre-diabetes or diabetes; 15% were diagnosed after the first attack of pancreatitis.↗
▶Ep 7 · 33:20
clinicalMixed meal tolerance testing is the ideal diabetes screening method for pancreatic disease patients, similar to CF-related diabetes, involving fasting glucose followed by Boost stimulant and measuring insulin, glucose, and C-peptide every 30 minutes for 2 hours.↗
▶Ep 7 · 34:50
clinicalDespite multiple trials, there is no single medical or dietary intervention that can prevent recurrent episodes or treat pain effectively in chronic pancreatitis.↗
▶Ep 7 · 35:10
clinicalLow fat diet, pancreatic enzymes (if no exocrine insufficiency), antioxidant cocktail, steroids, leukotriene antagonists, and somatostatins have not been shown to be helpful in chronic pancreatitis pain management.↗
▶Ep 7 · 35:30
clinicalCognitive behavioral therapy and physical therapy are effective in treating chronic pancreatitis pain when approached like other chronic pain conditions.↗
Maisam's statements about Acute Recurrent Pancreatitis19 statements
quoteWe are thrilled, excited to be with you today. While we give you updates, we will be going through your questions live that you send through the talk.↗
▶Ep 7 · 5:15
guidelineAcute pancreatitis is diagnosed when the patient has 2 out of 3 criteria: classic epigastric pain, lipase or amylase 3 times the upper limit of normal, and imaging findings.↗
▶Ep 7 · 5:30
guidelineAcute recurrent pancreatitis is defined as having more than 1 attack, typically separated by a 1 month free interval, but could be less than 1 month if there is normalization of enzymes and a pain-free period.↗
▶Ep 7 · 6:00
guidelineChronic pancreatitis requires imaging findings plus one of three: abdominal pain consistent with pancreatic origin, evidence of exocrine insufficiency, or endocrine insufficiency.↗
▶Ep 7 · 6:35
epidemiologicalNew cases of acute pancreatitis have an incidence in the United States of 1 in 10,000 cases, with up to a third developing recurrent attacks.↗
▶Ep 7 · 6:45
epidemiologicalChronic pancreatitis in the young population has an incidence of up to 2 per 100,000.↗
▶Ep 7 · 6:45
quoteFor us to advance the field further, we really need biomarkers for early disease.↗
▶Ep 7 · 14:20
epidemiologicalIn the International Study Group cohort of 300 pediatric pancreatitis patients, genetic causes were positive in 48% of acute recurrent pancreatitis patients and 33% of chronic pancreatitis patients when searching for one of 4 genes.↗
▶Ep 7 · 15:50
clinicalThe Cincinnati Children's 10-gene pancreatic genetic testing panel uses next generation sequencing with more than 50x coverage at every targeted base, with all pathogenic and novel variants confirmed by Sanger sequencing.↗
▶Ep 7 · 16:15
opinionVariants of unknown clinical significance are reported because what is a variant of unknown significance today might be reclassified as pathogenic or likely pathogenic later as more studies are done.↗
▶Ep 7 · 18:20
quoteWhy would a patient who does not smoke or drink alcohol in pediatric have pancreatitis, and she did not have anatomic abnormalities or any of the list of causes that I showed you.↗
▶Ep 7 · 20:40
quoteThis genetic testing was life changing, not just for the patient, but for her family as well.↗
▶Ep 7 · 22:00
clinicalGenetic testing should ideally be ordered as directed by a genetic counselor after discussing implications for the patient's future, medical insurance, offspring, and family members.↗
▶Ep 7 · 22:20
quoteIf the genetic counselor is not ordering the test, some, um, institutions cannot be reimbursed for it.↗
▶Ep 7 · 32:30
epidemiologicalIn a cross-sectional analysis of 52 chronic pancreatitis patients at Cincinnati Children's, 25% were diagnosed with either pre-diabetes or diabetes; 15% were diagnosed after the first attack of pancreatitis.↗
▶Ep 7 · 33:20
clinicalMixed meal tolerance testing is the ideal diabetes screening method for pancreatic disease patients, similar to CF-related diabetes, involving fasting glucose followed by Boost stimulant and measuring insulin, glucose, and C-peptide every 30 minutes for 2 hours.↗
▶Ep 7 · 34:50
clinicalDespite multiple trials, there is no single medical or dietary intervention that can prevent recurrent episodes or treat pain effectively in chronic pancreatitis.↗
▶Ep 7 · 35:10
clinicalLow fat diet, pancreatic enzymes (if no exocrine insufficiency), antioxidant cocktail, steroids, leukotriene antagonists, and somatostatins have not been shown to be helpful in chronic pancreatitis pain management.↗
▶Ep 7 · 35:30
clinicalCognitive behavioral therapy and physical therapy are effective in treating chronic pancreatitis pain when approached like other chronic pain conditions.↗
