Pancreatitis in children [letter].

"Hereditary pancreatitis" is important for at least three reasons: (1) It is 
probably not an uncommon form of pancreatitis in children and young 
adults; (2) the course of the disorder may be chronic, with 
substantial long-term morbidity, including an apparently increased risk for pancreatic cancer; 
and (3) once having made the correct diagnosis, occurrence among siblings 
and/or offspring (and perhaps other relatives) of the proband may be 
expected. Hereditary pancreatitis is an autosomal dominant trait with apparently complete 
penetrance, though markedly variable expressivity. It would be reasonable to point 
out that hereditary pancreatitis should be entertained whenever an alternative diagnosis 
is not documented, even without a positive family history. - We 
agree with the statement by Jordan and Ament in a recent 
article that "acute pancreatitis is one of the rarer causes of 
abdominal pain in children and is among the least reported and 
characterized." However, their discussion of this problem is surprisingly incomplete. Familial 
pancreatitis, one of the most important causes of pancreatitis in childhood, 
is not even mentioned; cystic fibrosis is barely acknowledged. These two 
conditions as well as hypolipoproteinemia and ascariasis (also not mentioned) should 
be included in the differential diagnosis of pancreatitis in children and 
of otherwise unexplained abdominal pain in this age group. - We 
appreciate the concern that we did not diagnose hereditary pancreatitis in 
any of our patients. None of the ten patients with "idiopathic 
pancreatitis" had a family history of pancreatitis documented in their charts. 
Cystic fibrosis (CF) is not a common cause of pancreatitis in 
our center. We chose to omit ascariasis from our differential diagnosis 
because in the developed countries it is unlikely to be a 
common cause of pancreatitis. 