Genetic variants in acute, acute recurrent and chronic pancreatitis affect the progression of disease in children

Background/objectives: Acute pancreatitis (AP) is emerging in pediatrics. A subset of children with AP progresses to acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP). The role of extensive gene testing in the progression has not been investigated previously. We have followed children enrolled in the registry and at our center for progression to ARP and CP after the first attack. Methods: This study utilizes an extensive gene sequencing panel as a platform to evaluate the role of genetics in first attack AP, and the progression over time, from first attack to ARP and CP in children. Results: Genes, with corresponding variants were involved in the 3 groups studied: AP, ARP and CP. We have shown that the presence of gene variants from the eight tested genes is enriched in the CP group compared to the AP and ARP groups. The presence of more than one gene was associated with CP (p = 0.01). SPINKI mutation(s) was significantly associated with faster progression to ARP, (p = 0.04). Having a variant from CFTR, SPINKI or PRSS1, was associated with the faster progression from AP to CP over time (p <0.05). Conclusions: This study shows that genetics have a significant role in progression to ARP and CP from the first attack of pancreatitis. (C) 2019 IAP and EPC. Published by Elsevier B.V. All rights reserved.