Tendency and risk factors of acute pancreatitis in children with severe motor and intellectual disabilities: A single-center study

Published:November 07, 2022DOI:



      Acute pancreatitis (AP) is a life-threatening disease in children with severe motor and intellectual disabilities (SMID). This study aimed to determine the clinical characteristics and causes of AP in children with SMID.


      We enrolled 29 children with AP admitted to our hospital. Patients were divided into children with SMID (AP with SMID group) and the remaining patients (AP without SMID group). All patients in the AP without SMID group had no pre-existing neurological disabilities. We obtained data on the clinical background of patients, severity of AP, treatments, and outcomes. We enrolled 34 children with SMID without a history of AP (SMID control group) to compare their clinical characteristics with the AP with SMID group. We statistically compared the data between the AP with SMID and AP without SMID groups and between the AP with SMID and SMID control groups.


      Compared to the AP without SMID group, the AP with SMID group showed significantly more severe pancreatitis (50% vs 12%) and recurrent pancreatitis (58% vs 18%). Moreover, compared with the SMID control group, the AP with SMID group showed significantly more frequent absence of voluntary movement (83% vs 26%), requirement of respiratory devices (75% vs 35%), panhypopituitarism (33% vs 6%), thermoregulatory dysfunction (58% vs 18%), and low serum albumin levels (3.6 vs 4.1 g/dL).


      AP in children with SMID tended to be associated with severe and recurrent pancreatitis. Children with SMID who had a history of AP had more severe neurological impairment among children with SMID. Hypothalamic-pituitary system dysfunction caused by severe cerebral damage may contribute to the development of AP.



      AP (acute pancreatitis), SMID (severe motor and intellectual disabilities), BSA (body surface area), BMI (body mass index), INSPPIRE (International study group of pediatric pancreatitis: in search for cure), TPN (total parenteral nutrition), TRH (Thyrotropin-releasing hormone)
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        • Uc A.
        • Husain S.Z.
        Pancreatitis in Children.
        Gastroenterology. 2019; 156: 1969-1978
      1. Oshima K. Basic problem of severely mentally and physically disabled children. Koshu Eisei (Tokyo) 1971;35:648–55. Japanese.

        • Cohen E.
        • Kuo D.Z.
        • Agrawal R.
        • Berry J.G.
        • Bhagat S.K.M.
        • Simon T.D.
        • et al.
        Children with medical complexity: an emerging population for clinical and research initiatives.
        Pediatrics. 2011; 127: 529-538
        • Grauso-Eby N.L.
        • Goldfarb O.
        • Feldman-Winter L.B.
        • McAbee G.N.
        Acute pancreatitis in children from Valproic acid: case series and review.
        Pediatr Neurol. 2003; 28: 145-148
        • Tamasaki A.
        • Nishimura Y.
        • Kondo N.
        • Shirai K.
        • Maegaki Y.
        • Ohno K.
        Risk factors for acute pancreatitis in patients with severe motor and intellectual disabilities.
        Pediatr Int. 2014; 56: 240-243
        • Hauer J.M.
        Central hypothermia as a cause of acute pancreatitis in children with neurodevelopmental impairment.
        Dev Med Child Neurol. 2008; 50: 68-70
        • Morinville V.D.
        • Husain S.Z.
        • Bai H.
        • Barth B.
        • Alhosh R.
        • Durie P.R.
        • et al.
        Definitions of pediatric pancreatitis and survey of present clinical practices.
        J Pediatr Gastroenterol Nutr. 2012; 55: 261-265
        • Suzuki M.
        • Saito N.
        • Naritaka N.
        • Nakano S.
        • Minowa K.
        • Honda Y.
        • et al.
        Scoring system for the prediction of severe acute pancreatitis in children.
        Pediatr Int. 2015; 57: 113-118
        • Kato N.
        • Takimoto H.
        • Sudo N.
        The cubic functions for spline smoothed L, S and M values for BMI reference data of Japanese Children.
        Clin Pediatr Endocrinol. 2011; 20: 47-49
        • Goldstein B.
        • Giroir B.
        • Randolph A.
        International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics.
        Pediatr Crit Care Med. 2005; 6: 2-8
        • Yokoe M.
        • Takada T.
        • Mayumi T.
        • Yoshida M.
        • Isaji S.
        • Wada K.
        • et al.
        Japanese guidelines for the management of acute pancreatitis: Japanese Guidelines 2015.
        J Hepatobiliary Pancreat Sci. 2015; 22: 405-432
        • Park A.
        • Latif S.U.
        • Shah A.U.
        • Tian J.
        • Werlin S.
        • Hsiao A.
        • et al.
        Changing referral trends of acute pancreatitis in children: A 12-year single-center analysis.
        J Pediatr Gastroenterol Nutr. 2009; 49: 316-322
        • Allen J.
        • Zareen Z.
        • Doyle S.
        • Whitla L.
        • Afzal Z.
        • Stack M.
        • et al.
        Multi-organ dysfunction in cerebral palsy.
        Front Pediatr. 2021; 9668544
        • Yoneda M.
        • Goto M.
        • Nakamura K.
        • Shimada T.
        • Hiraishi H.
        • Terano A.
        • et al.
        Protective effect of central thyrotropin-releasing hormone analog on cerulein-induced acute pancreatitis in rats.
        Regul Pept. 2005; 125: 119-124
        • Andraus W.
        • Jukemura J.
        • Dutra F.
        • Bechara E.
        • Cunha J.E.
        • Leite K.R.
        • et al.
        Oxidative stress is enhanced by hypothermia imposed on cerulein-induced pancreatitis in rats.
        Clinics (Sao Paulo). 2007; 62: 483-490
        • Savides E.P.
        • Hoffbrand B.I.
        Hypothermia, thrombosis, and acute pancreatitis.
        Br Med J. 1974; 1
        • Crozier S.J.
        • D'Alecy L.G.
        • Ernst S.A.
        • Ginsburg L.E.
        • Williams J.A.
        Molecular mechanisms of pancreatic dysfunction induced by protein malnutrition.
        Gastroenterology. 2009; 137: 1093-1101.e3