Skip to main content Skip to main navigation menu Skip to site footer

The management of acute pancreatitis among children on chronic ambulatory peritoneal dialysis during COVID-19 pandemic crisis in Indonesia: report of two cases

  • Agustina Wulandari ,
  • Risky Vitria Prasetyo ,
  • Muhammad Riza Kurniawan ,
  • Ninik Asmaningsih Soemyarso ,
  • Mohammad Sjaifullah Noer ,


Abstract

Background: Children on dialysis seem to be at greater risk for COVID-19. Acute pancreatitis (AP) is an infrequent but severe complication of chronic peritoneal dialysis (PD). It contributes to morbidity and mortality rates of up to 25%. Patients with PD are exposed to a series of factors associated with AP risk. This report aimed to describe rare and interesting cases of acute pancreatitis in children with CAPD following PD-related peritonitis with a favorable response to conservative treatment.

Case report: We present two cases admitted to our emergency room (ER) with severe abdominal pain preceded by PD-related peritonitis. Poor adherence, lack of monitoring, and healthcare service restriction during the COVID-19 pandemic predisposed these patients to PD-related complications. Patients were diagnosed as AP based on the revised Atlanta criteria. Both met the criteria as they had abdominal pain, a threefold increase of pancreatic enzymes, and evidence of pancreatitis through ultrasonography (USG) investigation. Both patients presented a rapid resolution of AP after receiving conservative treatment, including fasting, total parenteral nutrition (TPN), prophylactic antibiotics, and analgesics. None of them experienced invasive intervention due to AP.

Conclusion: Diagnosing AP in children with CAPD may be challenging since the symptoms mimic other abdominal problems. Our cases are likely to be associated with PD-related peritonitis. This report may prove conservative treatment as a recommendation for managing AP in children with CAPD. The rapid development of innovative clinical management strategies in response to the COVID-19 pandemic is crucial to improving children's health care quality with CAPD.

Keywords: chronic kidney disease peritoneal dialysis acute pancreatitis children

References

  1. International Society for Peritoneal Dialysis. ISPD: Strategies regarding COVID-19 in PD patients. International Society for Peritoneal Dialysis.
  2. Wang Y, Wang YC, Song SH, Zhang HX, Wang L, Ma XQ, et al. Follow-up management strategy for patients undergoing peritoneal dialysis during novel coronavirus pneumonia epidemic. European Review for Medical and Pharmacological Sciences [Internet]. 2020 [cited 2021 Aug 18];24(21):11402–8. Available from: https://dx.doi.org/10.26355/EURREV_202011_23633
  3. Figueiredo AE, Siqueira SL de, Poli-de-Figueiredo CE, d’Avila DO. Hand Hygiene in Peritoneal Dialysis Patients: A Comparison of Two Techniques. Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis [Internet]. 2013 Nov [cited 2021 Aug 18];33(6):655. Available from: /pmc/articles/PMC3862095/
  4. Vidal E, Alberici I, Verrina E. Acute pancreatitis in children on chronic maintenance dialysis. Pediatric Nephrology. 2019 Sep 1;34(9):1501–12.
  5. Golay V, Roychowdhary A. Acute pancreatitis in chronic kidney disease-A common but often misunderstood combination. Renal Failure. 2012 Nov;34(10):1338–40.
  6. Aliotta R, Zanoli L, Lauretta I, Giunta R, Ferrario S, Rastelli S, et al. Pancreatitis is a silent killer in peritoneal dialysis with difficult diagnostic approach. Clinical Medicine Insights: Case Reports. 2018 Jan 1;11.
  7. Sharma A, Montane B, Abitbol C, Zilleruelo G, Strauss J. Acute Pancreatitis (AP) in Pediatric End Stage Renal Disease (ESRD) Patients: 1835. Pediatric Research [Internet]. 1998 Apr [cited 2021 Jun 21];43(4):313–313. Available from: https://www.nature.com/articles/pr19981985
  8. Bai HX, Giefer M, Patel M, Orabi AI, Husain SZ. The Association of Primary Hyperparathyroidism with Pancreatitis. Journal of clinical gastroenterology [Internet]. 2012 Sep [cited 2021 Jul 26];46(8):656. Available from: /pmc/articles/PMC4428665/
  9. Misgar RA, Mathew V, Pandit K, Chowdhury S. Primary hyperparathyroidism presenting as recurrent acute pancreatitis: A case report and review of literature. Indian Journal of Endocrinology and Metabolism [Internet]. 2011 [cited 2021 Jul 26];15(1):54. Available from: /pmc/articles/PMC3079873/
  10. Diallo I, Fall CA, Ndiaye B, Mbaye M, Diedhiou I, Ndiaye AR, et al. Primary Hyperparathyroidism and Pancreatitis: A Rare Association with Multiple Facets. International Scholarly Research Notices. 2016 Sep 27; 2016: 1–4.
  11. Schaefer F, Warady BA. Peritoneal dialysis in children with end-stage renal disease. Nature Reviews Nephrology. 2011 Nov;7(11):659–68.
  12. Felderbauer P, Karakas E, Fendrich V, Lebert R, Bartsch D, Bulut K. Multifactorial genesis of pancreatitis in primary hyperparathyroidism: evidence for "protective" (PRSS2) and "destructive" (CTRC) genetic factors. Experimental and clinical endocrinology & diabetes: official journal, German Society of Endocrinology [and] German Diabetes Association [Internet]. 2011 [cited 2021 Sep 27];119(1):26–9. Available from: https://pubmed.ncbi.nlm.nih.gov/20625975/
  13. Aliotta R, Zanoli L, Lauretta I, Giunta R, Ferrario S, Rastelli S, et al. Pancreatitis is a silent killer in peritoneal dialysis with difficult diagnostic approach. Clinical Medicine Insights: Case Reports. 2018 Jan 1;11.
  14. Warady BA, Bashir M, Donaldson LA. Fungal peritonitis in children receiving peritoneal dialysis: A report of the NAPRTCS. Kidney International. 2000;58(1):384–9.
  15. Brewton E, DiBaise M, Payton D. A 51-year-old man with acute pancreatitis on peritoneal dialysis. Journal of the American Academy of Physician Assistants. 2015 Oct;28(10):1.
  16. Sato K, Hayashi M, Utsugi M, Ishizuka T, Takagi H, Mori M. Acute Pancreatitis in a Patient Treated with Micafungin [Internet]. Vol. 29, Clinical Therapeutics. 2007 [cited 2022 Jan 27]. Available from: https://dx.doi.org/10.1016/j.clinthera.2007.07.012
  17. Quinlan JD. Acute Pancreatitis. American Family Physician [Internet]. 2014 Nov 1 [cited 2021 Jul 26];90(9):632–9. Available from: www.aafp.org/afp.
  18. Autoimmune Disorders That Cause Pancreatitis: Digestive Disorders Associates and MDTEC: Gastroenterology [Internet]. [cited 2021 Jul 26]. Available from: https://www.dda.net/blog/autoimmune-disorders-that-cause-pancreatitis
  19. Huang J, Hung K, Yen C, Wu K, Tsai T. Systemic lupus erythematosus and peritoneal dialysis: outcomes and infectious complications - PubMed. Perit Dial Int [Internet]. 2001 [cited 2021 Sep 22];21(2):143–7. Available from: https://pubmed.ncbi.nlm.nih.gov/11330557/
  20. Liang C, Huang C, Wang I, Chang C, Chen K, Weng C, et al. Impact of renal survival on the course and outcome of systemic lupus erythematosus patients treated with chronic peritoneal dialysis. Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy [Internet]. 2010 Feb [cited 2021 Sep 22];14(1):35–42. Available from: https://pubmed.ncbi.nlm.nih.gov/20438518/
  21. Odama U, Shih D, Korbet S. Sclerosing peritonitis and systemic lupus erythematosus: a report of two cases - PubMed. Perit Dial Int [Internet]. 1999 [cited 2021 Sep 22];19(2):160–4. Available from: https://pubmed.ncbi.nlm.nih.gov/10357188/
  22. Dervenis C, Johnson C, Bassi C, Bradley E, Imrie C, McMahon M, et al. Diagnosis, objective assessment of severity, and management of acute pancreatitis. Santorini consensus conference. International journal of pancreatology : official journal of the International Association of Pancreatology [Internet]. 1999 Jun [cited 2021 Sep 22];25(3):195–210. Available from: https://pubmed.ncbi.nlm.nih.gov/10453421/
  23. Acute pancreatitis | Radiology Reference Article | Radiopaedia.org [Internet]. [cited 2021 Jul 9]. Available from: https://radiopaedia.org/articles/acute-pancreatitis
  24. Abu-El-Haija M, Kumar S, Quiros J, Balakrishnan K, Barth B, Bitton S, et al. Management of Acute Pancreatitis in the Pediatric Population: A Clinical Report From the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas Committee. Journal of pediatric gastroenterology and nutrition [Internet]. 2018 Jan 1 [cited 2021 Sep 22];66(1):159–76. Available from: https://pubmed.ncbi.nlm.nih.gov/29280782/
  25. Tenner S, Baillie J, DeWitt J, Vege S. American College of Gastroenterology guideline: management of acute pancreatitis. The American journal of gastroenterology [Internet]. 2013 [cited 2021 Sep 22];108(9):1400–15. Available from: https://pubmed.ncbi.nlm.nih.gov/23896955/
  26. Uhl W, Warshaw A, Imrie C, Bassi C, McKay C, Lankisch P, et al. IAP Guidelines for the Surgical Management of Acute Pancreatitis. Pancreatology : official journal of the International Association of Pancreatology (IAP) . [et al] [Internet]. 2002 May 28 [cited 2021 Sep 22];2(6):565–73. Available from: https://pubmed.ncbi.nlm.nih.gov/12435871/
  27. Cartwright EJ, ZS Goh Z, Foo M, Chan CM, Htay H, Griva K. eHealth interventions to support patients in delivering and managing peritoneal dialysis at home: A systematic review. Peritoneal Dialysis International. 2021 Jan 1;41(1):32–41.
  28. Brown EA, Perl J. Increasing Peritoneal Dialysis Use in Response to the COVID-19 Pandemic: Will It Go Viral? Journal of the American Society of Nephrology [Internet]. 2020 Sep 1 [cited 2021 Aug 19];31(9):1928–30. Available from: https://jasn.asnjournals.org/content/31/9/1928
  29. Nayak KS, Ronco C, Karopadi AN, Rosner MH. Telemedicine and Remote Monitoring: Supporting the Patient on Peritoneal Dialysis. Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis [Internet]. 2016 Jul 1 [cited 2021 Aug 19];36(4):362. Available from: /pmc/articles/PMC4934427/
  30. Russo R, Manili L, Tiraboschi G, Amar K, de Luca M, Alberghini E, et al. Patient retraining in peritoneal dialysis: why and when it is needed. Kidney international Supplement [Internet]. 2006 Nov [cited 2021 Aug 19];70(103). Available from: https://pubmed.ncbi.nlm.nih.gov/17080104/
  31. Bordin G, Casati M, Sicolo N, Zuccherato N, Eduati V. Patient education in peritoneal dialysis: an observational study in Italy. Journal of renal care [Internet]. 2007 [cited 2021 Aug 19];33(4):165–71. Available from: https://pubmed.ncbi.nlm.nih.gov/18298034/
  32. Williams K, Ruiz F, Hernandez F, Hancock M. Home visiting: A lifeline for families during the COVID-19 pandemic. Archives of Psychiatric Nursing [Internet]. 2021 Feb 1 [cited 2021 Aug 19];35(1):129. Available from: /pmc/articles/PMC7581421/

How to Cite

Agustina Wulandari, Risky Vitria Prasetyo, Muhammad Riza Kurniawan, Ninik Asmaningsih Soemyarso, & Mohammad Sjaifullah Noer. (2022). The management of acute pancreatitis among children on chronic ambulatory peritoneal dialysis during COVID-19 pandemic crisis in Indonesia: report of two cases. Bali Medical Journal, 11(2), 514–519. https://doi.org/10.15562/bmj.v11i2.3422
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
0

Total
1

Share

Search Panel

Agustina Wulandari
Google Scholar
Pubmed
BMJ Journal

Risky Vitria Prasetyo
Google Scholar
Pubmed
BMJ Journal

Muhammad Riza Kurniawan
Google Scholar
Pubmed
BMJ Journal

Ninik Asmaningsih Soemyarso
Google Scholar
Pubmed
BMJ Journal

Mohammad Sjaifullah Noer
Google Scholar
Pubmed
BMJ Journal