Chronic pancreatitis with polycystic kidney disease: A rare coincidence?

Nefrologia (Engl Ed). 2020 May-Jun;40(3):351-355. doi: 10.1016/j.nefro.2019.09.003. Epub 2019 Dec 18.
[Article in English, Spanish]

Abstract

Introduction: In children, chronic pancreatitis (CP) is usually associated with anatomical anomalies of the pancreas and biliary tract or is genetically determined. Autosomal dominant polycystic kidney disease (ADPKD) may present with extrarenal cyst formation, sometimes involving the pancreas. Large enough, these cysts may cause pancreatitis in ADPKD patients.

Case presentation: Herein, we present a case of a 12-year-old Caucasian girl with recurrent pancreatitis with no identifiable traumatic, metabolic, infectious, drug, or immunologic causes. Structural anomalies of the pancreas, including cysts, were ruled out by imaging. However, bilateral cystic kidneys were found as an incidental finding. Her family history was negative for pancreatitis, but positive for polycystic kidney disease. Molecular analysis of ADPKD-causing mutations revealed a novel c.9659C>A (p.Ser3220*) mutation in the PKD1 gene confirming the clinical suspicion of ADPKD. Although CP may rarely occur as an extrarenal manifestation of ADPKD with pancreatic cysts, it is unusual in their absence. Thus, molecular analysis of pancreatitis susceptibility genes was performed and a homozygous pathologic c.180C>T (p.G60=) variant of the CTRC gene, known to increase the risk of CP, was confirmed.

Conclusion: This is the first reported case of a pediatric patient with coincidence of genetically determined CP and ADPKD. Occurrence of pancreatitis in children with ADPKD without pancreatic cysts warrants further investigation of CP causing mutations.

Keywords: ADPKD; Autosomal dominant polycystic kidney disease; CTRC gene; Chronic pancreatitis; Gen CTRC; Gen PKD1; PKD1 gene; Pancreatic cyst; Pancreatitis crónica; Quiste pancreático.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Causality
  • Child
  • Chymotrypsin / genetics*
  • Codon, Nonsense
  • Female
  • Genotype
  • Humans
  • Mutation, Missense
  • Pancreatitis, Chronic / complications*
  • Pancreatitis, Chronic / diagnostic imaging
  • Pancreatitis, Chronic / genetics
  • Pedigree
  • Point Mutation
  • Polycystic Kidney, Autosomal Dominant / complications*
  • Polycystic Kidney, Autosomal Dominant / genetics
  • Recurrence
  • TRPP Cation Channels / genetics*

Substances

  • Codon, Nonsense
  • TRPP Cation Channels
  • polycystic kidney disease 1 protein
  • Chymotrypsin
  • chymotrypsin C