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{{Chronic pancreatitis}}
{{Chronic pancreatitis}}
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==Overview==
The M-ANNHEIM multiple [[risk factor]] classification of chronic pancreatitis includes multiple [[risk factors]] such as [[alcohol consumption]], [[nicotine]] consumption, [[nutritional]] factors, [[hereditary]] factors, [[Efferent ducts|efferent duct]] factors, [[immunological]] factors, miscellaneous and rare [[metabolic]] factors. Common [[risk factors]] may include [[alcohol abuse]], [[cigarette smoking]], [[genetic mutations]] (PRSS1 [[mutations]], [[SPINK1]] [[mutations]], [[Cystic fibrosis transmembrane conductance regulator|CFTR]] [[mutations]], and CTRC [[mutations]]), obstructive causes and [[hypercalcemia]]. Less common [[risk factors]] include [[sphincter of Oddi dysfunction]], [[hyperlipidemia]], [[metabolic diseases]] such as branched-chain organic aciduria and [[chronic renal failure]].
==Risk Factors==
The M-ANNHEIM multiple risk factor classification of chronic pancreatitis
{| class="wikitable"
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Risk factor
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Sub-category
|-
|'''M'''ultiple risk factors
|
|-
|'''A'''lcohol consumption
|
* Excessive consumption (>80 g/day)
* Increased consumption (20–80 g/day)
* Moderate consumption (<20 g/day)
|-
|'''N'''icotine consumption
|
* In [[Smoking|cigarette smokers]]: description of [[nicotine]] consumption by pack-years
|-
|'''N'''utritional factors
|
* [[Nutrition]] (e.g., high caloric proportion of fat and protein)
* [[Hyperlipidemia]]
|-
|'''H'''ereditary factors
|
* [[Hereditary pancreatitis]] 
* Familial pancreatitis 
* Early-onset idiopathic pancreatitis
* Late-onset idiopathic pancreatitis
* Tropical pancreatitis (possible mutations in the PRSS1, [[CFTR (gene)|CFTR]], or [[SPINK1]] [[genes]])
|-
|'''E'''fferent duct factors
|
* [[Pancreas divisum]]
* [[Annular pancreas]] and other [[Congenital disorder|congenital]] abnormalities of the [[pancreas]]
* [[Pancreatic duct]] obstruction (e.g., [[tumors]])
* Posttraumatic [[pancreatic duct]] scars
* [[Sphincter of Oddi dysfunction]]
|-
|'''I'''mmunological Factors
|
* [[Autoimmune pancreatitis]]
* [[Sjögren's syndrome|Sjögren syndrome]]-associated chronic pancreatitis
* [[Inflammatory bowel disease]]-associated chronic pancreatitis
* Chronic pancreatitis with autoimmune diseases (e.g., [[primary sclerosing cholangitis]], [[primary biliary cirrhosis]])
|-
|'''M'''iscellaneous and rare metabolic factors
|
* [[Hypercalcemia]] and [[hyperparathyroidism]]
* [[Chronic renal failure]]
* Drugs
* Toxins
|}
===Common risk factors===
Common risk factors in the development of chronic pancreatitis include:
*[[Alcohol abuse]]<ref name="pmid11842000">{{cite journal |vauthors=Lu Z, Karne S, Kolodecik T, Gorelick FS |title=Alcohols enhance caerulein-induced zymogen activation in pancreatic acinar cells |journal=Am. J. Physiol. Gastrointest. Liver Physiol. |volume=282 |issue=3 |pages=G501–7 |year=2002 |pmid=11842000 |pmc=2830557 |doi=10.1152/ajpgi.00388.2001 |url=}}</ref><ref name="pmid6725910">{{cite journal |vauthors=Bisceglie AM, Segal I |title=Cirrhosis and chronic pancreatitis in alcoholics |journal=J. Clin. Gastroenterol. |volume=6 |issue=3 |pages=199–200 |year=1984 |pmid=6725910 |doi= |url=}}</ref><ref name="pmid4029715">{{cite journal |vauthors=Wilson JS, Bernstein L, McDonald C, Tait A, McNeil D, Pirola RC |title=Diet and drinking habits in relation to the development of alcoholic pancreatitis |journal=Gut |volume=26 |issue=9 |pages=882–7 |year=1985 |pmid=4029715 |pmc=1432860 |doi= |url=}}</ref><ref name="pmid14576495">{{cite journal |vauthors=Whitcomb DC |title=Genetic predisposition to alcoholic chronic pancreatitis |journal=Pancreas |volume=27 |issue=4 |pages=321–6 |year=2003 |pmid=14576495 |doi= |url=}}</ref><ref name="pmid15753536">{{cite journal |vauthors=Maisonneuve P, Lowenfels AB, Müllhaupt B, Cavallini G, Lankisch PG, Andersen JR, Dimagno EP, Andrén-Sandberg A, Domellöf L, Frulloni L, Ammann RW |title=Cigarette smoking accelerates progression of alcoholic chronic pancreatitis |journal=Gut |volume=54 |issue=4 |pages=510–4 |year=2005 |pmid=15753536 |pmc=1774435 |doi=10.1136/gut.2004.039263 |url=}}</ref><ref name="pmid15089909">{{cite journal |vauthors=Morton C, Klatsky AL, Udaltsova N |title=Smoking, coffee, and pancreatitis |journal=Am. J. Gastroenterol. |volume=99 |issue=4 |pages=731–8 |year=2004 |pmid=15089909 |doi=10.1111/j.1572-0241.2004.04143.x |url=}}</ref>
*[[Cigarette smoking]]<ref name="pmid21029787">{{cite journal |vauthors=Coté GA, Yadav D, Slivka A, Hawes RH, Anderson MA, Burton FR, Brand RE, Banks PA, Lewis MD, Disario JA, Gardner TB, Gelrud A, Amann ST, Baillie J, Money ME, O'Connell M, Whitcomb DC, Sherman S |title=Alcohol and smoking as risk factors in an epidemiology study of patients with chronic pancreatitis |journal=Clin. Gastroenterol. Hepatol. |volume=9 |issue=3 |pages=266–73; quiz e27 |year=2011 |pmid=21029787 |pmc=3043170 |doi=10.1016/j.cgh.2010.10.015 |url=}}</ref><ref name="pmid19506173">{{cite journal |vauthors=Yadav D, Hawes RH, Brand RE, Anderson MA, Money ME, Banks PA, Bishop MD, Baillie J, Sherman S, DiSario J, Burton FR, Gardner TB, Amann ST, Gelrud A, Lawrence C, Elinoff B, Greer JB, O'Connell M, Barmada MM, Slivka A, Whitcomb DC |title=Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis |journal=Arch. Intern. Med. |volume=169 |issue=11 |pages=1035–45 |year=2009 |pmid=19506173 |doi=10.1001/archinternmed.2009.125 |url=}}</ref><ref name="pmid1752475">{{cite journal |vauthors=Bourliere M, Barthet M, Berthezene P, Durbec JP, Sarles H |title=Is tobacco a risk factor for chronic pancreatitis and alcoholic cirrhosis? |journal=Gut |volume=32 |issue=11 |pages=1392–5 |year=1991 |pmid=1752475 |pmc=1379175 |doi= |url=}}</ref>
*[[Genetic mutations]]:
**PRSS1 [[mutations]]
**[[SPINK1]] [[mutations]]
**[[CFTR]] [[mutations]]
**CTRC [[mutations]]
*Obstructive factors:
**[[Pancreas divisum]]
**[[Gallstones]]
**[[Pancreatic duct]] malunion or obstruction
**[[Choledocholithiasis]]
**[[Pancreatic cancer|Pancreatic head tumors]]
*Hypercalcemia
=== Less common risk factors ===
Less common [[risk factors]] in the development of chronic pancreatitis include:
*[[Sphincter of Oddi dysfunction]]<ref name="pmid9219783">{{cite journal |vauthors=Tarnasky PR, Hoffman B, Aabakken L, Knapple WL, Coyle W, Pineau B, Cunningham JT, Cotton PB, Hawes RH |title=Sphincter of Oddi dysfunction is associated with chronic pancreatitis |journal=Am. J. Gastroenterol. |volume=92 |issue=7 |pages=1125–9 |year=1997 |pmid=9219783 |doi= |url=}}</ref>
*[[Hyperlipidemia]]
*[[Metabolic diseases]] such as branched-chain organic aciduria
*[[Chronic renal failure]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 19:11, 31 January 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]

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Overview

The M-ANNHEIM multiple risk factor classification of chronic pancreatitis includes multiple risk factors such as alcohol consumption, nicotine consumption, nutritional factors, hereditary factors, efferent duct factors, immunological factors, miscellaneous and rare metabolic factors. Common risk factors may include alcohol abuse, cigarette smoking, genetic mutations (PRSS1 mutations, SPINK1 mutations, CFTR mutations, and CTRC mutations), obstructive causes and hypercalcemia. Less common risk factors include sphincter of Oddi dysfunction, hyperlipidemia, metabolic diseases such as branched-chain organic aciduria and chronic renal failure.

Risk Factors

The M-ANNHEIM multiple risk factor classification of chronic pancreatitis

Risk factor Sub-category
Multiple risk factors
Alcohol consumption
  • Excessive consumption (>80 g/day)
  • Increased consumption (20–80 g/day)
  • Moderate consumption (<20 g/day)
Nicotine consumption
Nutritional factors
Hereditary factors
  • Hereditary pancreatitis
  • Familial pancreatitis
  • Early-onset idiopathic pancreatitis
  • Late-onset idiopathic pancreatitis
  • Tropical pancreatitis (possible mutations in the PRSS1, CFTR, or SPINK1 genes)
Efferent duct factors
Immunological Factors
Miscellaneous and rare metabolic factors

Common risk factors

Common risk factors in the development of chronic pancreatitis include:

Less common risk factors

Less common risk factors in the development of chronic pancreatitis include:

References

  1. ↑ Lu Z, Karne S, Kolodecik T, Gorelick FS (2002). "Alcohols enhance caerulein-induced zymogen activation in pancreatic acinar cells". Am. J. Physiol. Gastrointest. Liver Physiol. 282 (3): G501–7. doi:10.1152/ajpgi.00388.2001. PMC 2830557. PMID 11842000.
  2. ↑ Bisceglie AM, Segal I (1984). "Cirrhosis and chronic pancreatitis in alcoholics". J. Clin. Gastroenterol. 6 (3): 199–200. PMID 6725910.
  3. ↑ Wilson JS, Bernstein L, McDonald C, Tait A, McNeil D, Pirola RC (1985). "Diet and drinking habits in relation to the development of alcoholic pancreatitis". Gut. 26 (9): 882–7. PMC 1432860. PMID 4029715.
  4. ↑ Whitcomb DC (2003). "Genetic predisposition to alcoholic chronic pancreatitis". Pancreas. 27 (4): 321–6. PMID 14576495.
  5. ↑ Maisonneuve P, Lowenfels AB, Müllhaupt B, Cavallini G, Lankisch PG, Andersen JR, Dimagno EP, Andrén-Sandberg A, Domellöf L, Frulloni L, Ammann RW (2005). "Cigarette smoking accelerates progression of alcoholic chronic pancreatitis". Gut. 54 (4): 510–4. doi:10.1136/gut.2004.039263. PMC 1774435. PMID 15753536.
  6. ↑ Morton C, Klatsky AL, Udaltsova N (2004). "Smoking, coffee, and pancreatitis". Am. J. Gastroenterol. 99 (4): 731–8. doi:10.1111/j.1572-0241.2004.04143.x. PMID 15089909.
  7. ↑ Coté GA, Yadav D, Slivka A, Hawes RH, Anderson MA, Burton FR, Brand RE, Banks PA, Lewis MD, Disario JA, Gardner TB, Gelrud A, Amann ST, Baillie J, Money ME, O'Connell M, Whitcomb DC, Sherman S (2011). "Alcohol and smoking as risk factors in an epidemiology study of patients with chronic pancreatitis". Clin. Gastroenterol. Hepatol. 9 (3): 266–73, quiz e27. doi:10.1016/j.cgh.2010.10.015. PMC 3043170. PMID 21029787.
  8. ↑ Yadav D, Hawes RH, Brand RE, Anderson MA, Money ME, Banks PA, Bishop MD, Baillie J, Sherman S, DiSario J, Burton FR, Gardner TB, Amann ST, Gelrud A, Lawrence C, Elinoff B, Greer JB, O'Connell M, Barmada MM, Slivka A, Whitcomb DC (2009). "Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis". Arch. Intern. Med. 169 (11): 1035–45. doi:10.1001/archinternmed.2009.125. PMID 19506173.
  9. ↑ Bourliere M, Barthet M, Berthezene P, Durbec JP, Sarles H (1991). "Is tobacco a risk factor for chronic pancreatitis and alcoholic cirrhosis?". Gut. 32 (11): 1392–5. PMC 1379175. PMID 1752475.
  10. ↑ Tarnasky PR, Hoffman B, Aabakken L, Knapple WL, Coyle W, Pineau B, Cunningham JT, Cotton PB, Hawes RH (1997). "Sphincter of Oddi dysfunction is associated with chronic pancreatitis". Am. J. Gastroenterol. 92 (7): 1125–9. PMID 9219783.


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