Recommendations for Diagnosis and Management of Autoimmune Pancreatitis in Childhood: Consensus from INSPPIRE

Objectives: Autoimmune pancreatitis (AIP) represents a complex immune-mediated pancreas disorder. Pediatric AIP (P-AIP) is rare. We have recently summarized the characteristic features of P-AIP. We now aim to develop recommendation statements to standardize the diagnostic and therapeutic approach to P-AIP and facilitate future research in the field. Methods: A panel of pediatric gastroenterologists participating in the International Study Group of Pediatric Pancreatitis: In search for a cuRE (INSPPIRE) was formed to discuss and then vote on 15 recommendation statements. A consensus of at least 80% was obtained following 3 voting rounds and revision of the statements. Results: We have now generated 15 statements to help standardize the approach to diagnosis and management of P-AIP. Conclusions: The first P-AIP recommendation statements developed by the INSPPIRE group are intended to bring standardization to the diagnosis and treatment of this rare childhood disorder. These statements may help guide a uniform approach to patient care and facilitate future research studies. Address correspondence and reprint requests to Tanja Gonska, MD, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1H4 (e-mail: tanja.gonska@sickkids.ca). Received 14 August, 2017 Accepted 18 March, 2018 Aliye Uc and Tanja Gonska are Equal senior authors. Grant support: This work was supported by NIH DK096327 (AU), DK108334 (AU); by National Pancreas Foundation (AU); INSPPIRE registry was developed by CTSA (2UL1 TR000442) and REDCap. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Disclosures: ML is consultant for AbbVie, Inc.; Nordmark Arzneimittel GmbH & Co. KG; is in the Board of Directors of the National Pancreas Association; receives royalties from Millipore Inc. IS is supported by a Restracomp Grant and a Fondation St Luc Grant. TG received a research grant from Vertex Pharmaceuticals. AU is a member of the American Board of Pediatrics, Subboard of Pediatric Gastroenterology. Author contributions: IS: study design, acquisition of data, analysis and interpretation of data, voting panel, statistical analysis, drafting of the manuscript. JJP, SF, MW, US: member of the AIP working group within INSPPIRE, acquisition of data, voting panel, critical revision of the manuscript for important intellectual content. AM, BB, DF, CG, MG, MH, RH, SH, TL, QL, ML, MM, VM, CO, EP, DP, JFP, SS, DT, SW: voting panel, critical revision of the manuscript. AU: member of the AIP working group within INSPPIRE, voting panel, acquisition of data, critical revision of the manuscript for important intellectual content, obtained funding, study supervision. TG: member of the AIP working group within INSPPIRE, study concept and design, acquisition of data, voting panel, drafting and critical revision of the manuscript for important intellectual content, study supervision. The other authors have no disclosure or conflict of interest. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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