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Pediatr Blood Cancer. 2019 Jan;66(1):e27437. doi: 10.1002/pbc.27437. Epub 2018 Sep 14.

Insulin-dependent diabetes: A chronic complication to acute pancreatitis in childhood acute lymphoblastic leukemia.

Author information

1
Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark.
2
Diabetes and Bone-Metabolic Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark.
3
Department of Pediatrics, Institution for Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden.
4
Department of Pediatrics, Linköping University Hospital, Linköping, Sweden.
5
Department of Pediatrics, Astrid Lindgren's Hospital, Stockholm, Sweden.
6
Tampere Center for Child Health Research, Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Tampere, Finland.
7
Department of Clinical Sciences and Pediatrics, Umea University, Umea, Sweden.
8
Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway.
9
Institute of Clinical Medicine, University of Copenhagen, Denmark.

Abstract

Pancreatitis is a frequent toxicity to acute lymphoblastic leukemia (ALL) treatment, significantly associated with asparaginase use, and may be followed by severe complications such as acute hyperglycaemia, need for mechanical ventilation, pseudocysts, and death. Here, we provide novel data on seven patients diagnosed with diabetes after pancreatitis and still requiring insulin treatment after a median follow-up of 4.2 years (range: 1.7-9.2). We describe the clinical course of pancreatitis and illustrate the association between pancreatic pseudocysts, older age, and development of insulin-dependent diabetes. Together, this study documents the persisting burden of pancreatitis in childhood ALL and underlines the need for plasma glucose level monitoring.

KEYWORDS:

acute lymphoblastic leukemia; diabetes; pancreatitis; toxicity

PMID:
30216644
DOI:
10.1002/pbc.27437

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