We are happy to draw your attention to the PINEAPPLE (Pain IN EArly phase of Pediatric Pancreatitis) study initiated by the Hungarian Pancreatic Study Group. The protocol of the study had been discussed and accepted by professionals on an international conference, received the necessary ethical approvals, had been registered (ISRCTN35618458) and the study protocol is already published ( http://www.ncbi.nlm.nih.gov/pubmed/26641250 ) . This study has also been endorsed by the scientific committee of IAP. Eight centers have already joined the study.

The documented incidence of pediatric pancreatitis is less than 1/100,000 in almost all European countries and it decreases from Western- to Eastern Europe. According to two major studies, in the USA and in Australia the incidence is 3.6 and 13.2 in 100.000. Financial problems can definitely lead to this phenomen, but the more important problem is, that no evidence-based (EBM) guidelines are available and we do not think enough about pancreatitis in childhood.

The PINEAPPLE-R subtrial is a retrospective review on children (patients under 18) records appearing at ER units, whereas, the PINEAPPLE-P subtrial is the prospective part of the study where detailed patients data (concerning medical history, complaints, symptoms, physical examination) are collected, PEM and abdominal imaging are performed in all cases. Until now 23644 patients records/PINEAPPLE-R and 156 patients/PINEAPPLE-P were enrolled from 8 pediatric centres. Our early results clearly shows, that we need to collect more data. We need around 100.000 data of patients for the PINEAPPLE-R and above 5.000 patients for the PINEAPPLE-P to to understand the current practice of diagnosis of PP and to develop EBM guidelines that helps to evaluate (in a reliable and cost efficient way) the necessity of pancreatic enzyme measurement (PEM) and abdominal ultrasonography when a child has abdominal pain.

Parameters listed in the study protocol; data must be obtained from the detailed medical history, physical examination, pancreatic enzymes measurements and abdominal imaging for filling out the questionnaire. The details of the study can be found at http://pancreas.hu/en/studies/pineapple . You will also find authorship rules for active participants.

Your intent to join is welcome, your cooperation is highly appreciated!

Sincerely yours,

Prof Peter Hegyi, Chair, Hungarian Pancreatic Study Group
Prof Philippe Lévy, Chair of IAP Scientific Committee