The purpose of the study was to analyze the clinical characteristics and the course of diagnosis and
therapy of
asparaginase-associated
pancreatitis (
AAP) in childhood, improve the ability of diagnosis and treatment, and evaluate ULK2 gene polymorphism as a predictive factor for
AAP. Data of 12 patients with childhood
AAP were reviewed. Sanger sequencing of ULK2 gene was performed in
AAP group (n=12) and control group (n=146). The main symptoms of
AAP were
abdominal pain and
vomiting. Generally, the levels of
amylase and
lipase in the serum peaked within 72 h. Abdominal ultrasonography was performed in 11 patients; seven patients exhibited findings of pancreatic enlargement. Computed tomography was performed in 9 patients. Five patients exhibited findings of pancreatic enlargement and peri-pancreatic exudation. All patients were managed by fasting at the early stage, and seven patients underwent placement of a nasojejunal tube to receive
enteral nutrition. One patient underwent endoscopic retrograde cholangiopancreatography (revealing dilation of the pancreatic duct) and endoscopic retrograde pancreatic drainage. Another patient developed signs of
shock and received continuous renal replacement. There were no deaths caused by
AAP. Therefore, early identification of patients at risk of
AAP is of great importance. In addition, repeated elevation in the levels of pancreatic
enzymes is indicative of complications. Sanger sequencing analysis of ULK2 gene showed that there was a significant difference of EXON1: -493C>T and EXON1: -308C>G between the
AAP group and control group (P<0.0001). Thus, ULK2 gene polymorphism may be associated with the development of
AAP. However, more validation of this finding is needed.