Nationwide survey of hereditary pancreatitis in Japan

• Published in: Journal of gastroenterology Vol. 53; no. 1; pp. 152 - 160
• Main Authors: Masamune, Atsushi, Kikuta, Kazuhiro, Hamada, Shin, Nakano, Eriko, Kume, Kiyoshi, Inui, Ayano, Shimizu, Toshiaki, Takeyama, Yoshifumi, Nio, Masaki, Shimosegawa, Tooru
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.01.2018; Springer; Springer Nature B.V
• Subjects: Abdominal Surgery; Adolescent; Adult; Age of Onset; Aged; Biliary Tract; Child; Child, Preschool; Colorectal Surgery; Development and progression; Diabetes; Diabetes mellitus; Diabetes Mellitus - epidemiology; Endoscopy; Epidemiology; Exocrine Pancreatic Insufficiency - epidemiology; Family; Female; Gastroenterology; Genetic Predisposition to Disease; Genetic screening; Genetic Testing; Health aspects; Hepatology; Hospitals; Humans; Japan - epidemiology; Male; Medical colleges; Medicine; Medicine & Public Health; Middle Aged; Mutation; Original Article—Liver; Pancreas; Pancreatic cancer; Pancreatic Neoplasms - epidemiology; Pancreatic Neoplasms - genetics; Pancreatic Neoplasms - surgery; Pancreatitis; Pancreatitis, Chronic - epidemiology; Pancreatitis, Chronic - genetics; Pancreatitis, Chronic - surgery; Surgery; Surgical Oncology; Surveys; Surveys and Questionnaires; Trypsin - genetics; Trypsin Inhibitor, Kazal Pancreatic - genetics; Young Adult; Japan; Trypsin; Trypsinogen; Recurrent pancreatitis; Chronic pancreatitis; Pancreatic cancer
• ISSN: 0944-1174; 1435-5922
• DOI: 10.1007/s00535-017-1388-0

Background Hereditary pancreatitis (HP) is a rare cause of chronic pancreatitis. We here report a nationwide survey to clarify the epidemiological, genetic, and clinical features of HP in Japan. Methods Target subjects were patients with HP and their family members who had visited selected hospitals between 2005 and 2014. This study consisted of two-stage surveys; patients with HP were identified by the first questionnaire and their clinical features were assessed by the second questionnaire. Results Two hundred seventy-one patients (153 males and 118 females) in 100 families diagnosed based on the Japanese criteria or 231 patients (131 males and 100 females) patients in 80 families based on the EUROPAC criteria were reported. Of the families undertaking genetic tests, 41% had the PRSS1 mutations (p.R122H 33%, p.N29I 8%) and 36% had the SPINK1 mutations (p.N34S 22%, c.194+2T>C 14%, p.P45S 1%). The mean age at symptom onset was 17.8 years. The cumulative rates of pancreatic exocrine insufficiency and diabetes mellitus were 16.1 and 5.5% at 20 years old, and 45.3 and 28.2% at 40 years, respectively. Forty-four percent of the patients underwent endoscopic treatment and/or surgery. The cumulative rate of pancreatic cancer diagnosis was 2.8% at 40 years old, 10.8% at 60 years, and 22.8% at 70 years. Conclusions HP was characterized by early disease onset, frequent development of pancreatic exocrine insufficiency and diabetes mellitus, requirement of endoscopic treatment and/or surgery, and increased risk of pancreatic cancer. PRSS1 and SPINK1 mutations serve as genetic background for HP in Japan.