Pancreatitis in enterica among Egyptian children

Fifty children [30 males and 20 females] diagnosed as typhoid fever were randomly chosen among those admitted to Abbassia fever hospital. Their ages ranged between 3-12 years [8.35 +/- 2.62 years]. History-taking, clinical examination and laboratory investigations including CBC, ESR, Widal test, blood culture, serum [SYMBOL 97 /F Symbol] amylase and serum lipase were assessed twice; at admission and 10 days later. A cohort of 20 healthy children served as the control group. The study showed that serum amylase and serum lipase [210.12 +/- 45.34 U/L and 180.35 +/- 20.45 U/L respectively] were significantly higher than those levels among the control group [86.34 +/- 30.45 U/L and 95.44 +/- 23.76 U/L respectively]. The levels decreased significantly 10 days after the start of specific therapy; near to normal levels [90.12140.65 U/L and 99.56 +/- 34.45 U/L respectively]. Considering a cut off value of 145 U/L for serum amylase and 140 U/L for serum lipase, it was clear that pancreatic involvement was evident among 37 [74%] cases or 33 [66%] cases according to their serum levels of amylase and lipase respectively. Addingly, symptomatic cases with vomiting, epigastric tenderness and hypotension are associated with significantly higher levels of serum amylase [290.78 +/- 25.67 U/L, 310.23 =/- 7.60 U/L and 295.46 +/- 22.50 U/L respectively] and serum lipase [220.56 +/- 27.89 U/L, 230.56 +/- 10.54 and 219.34 +/- 13.24 U/L respectively] than cases without these findings. We can conclude that pancreatic invovement is a common finding among children with typhoid fever. This involvement can be expected in the presence of vomiting, epigastric tenderness and/or hypotension and predicted with a higher accuracy by serum pancreatic amylase and/or lipase assessment