PANCREATITIS IN CHILDREN INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS

The incidence of pancreatitis in HIV-infected children is not well kno wn. Medical records of 42 children with HIV infection followed at Chil dren's Hospital during a 6-year period were reviewed. Pancreatitis (el evated serum lipase levels) developed in 10 children (23.8%). Three ch ildren acquired HIV infection from vertical transmission and seven fro m contaminated blood products (hemophiliacs). Nine were severely immun osuppressed (CD4(+) of <100 cells/mm(3)). Lipase values were more ofte n elevated than amylase values. The clinical course was protracted and severe in two children, one had four recurrences, and seven had only a single episode of pancreatitis lasting a few weeks. Opportunistic in fections were present in four children and seven were receiving medica tions previously implicated as cause of pancreatitis. Discontinuation of dideoxynosine (ddI) in one child led to rapid resolution of pancrea titis, but continuation of medications in the other children did not a lter the course. The etiology of pancreatitis may be multifactorial. S evere and prolonged clinical course is associated with advanced HIV in fection. Determination of serum lipase is more useful than serum amyla se for identifying those with pancreatitis.