Hereditary pancreatitis (HP) is a rare disorder characterized by recurrent attacks of acute pancreatitis, chronic pancreatitis, and a high incidence of adenocarcinoma of the pancreas. Hereditary pancreatitis specifically refers to otherwise unexplained pancreatitis in an individual from a family in which the pancreatitis phenotype appears to be inherited through a disease-causing gene mutation that is expressed in an autosomal dominant pattern (1). Familial pancreatitis refers to pancreatitis from any cause that occurs in a family with an incidence greater than expected by chance alone, given the size of the family and incidence of pancreatitis within a defined population (1). HP typically presents in childhood with an attack of acute pancreatitis. Recurrent acute pancreatitis advances to become chronic pancreatitis in about 50% of patients (2, 3). Chronic pancreatitis is a progressive inflammatory process that destroys pancreatic function and results in the malabsorption of nutrients (exocrine failure) and diabetes mellitus (endocrine failure). Additional complications of chronic pancreatitis that are seen in many, but not all, patients include severe and persistent pain, strictures of the common bile duct, pancreatic pseudocysts, and pancreatic duct stones that may require interventional or surgical treatment. Of those patients who develop a chronic course, about 40% develop pancreatic cancer (PC) (4, 5).
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Whitcomb DC. Hereditary diseases of the pancreas. In: Yamada T, Albers DH, Laine L, et al. (eds.) Textbook of gastroenterology. Philadelphia, Lippincott Williams & Wilkins, 2003, 2147–2165.
Gorry MC, Gabbaizedeh D, Furey W, et al. Mutations in the cationic trypsinogen gene are associated with recurrent acute and chronic pancreatitis. Gastroenterology 1997, 113(4):1063–1068.
Whitcomb DC. Hereditary pancreatitis: new insights into acute and chronic pancreatitis. Gut 1999, 45:317–322.
L owenfels AB, Maisonneuve P, Cavallini G, et al. Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. N Engl J Med 1993, 328(20):1433–1437.
Lowenfels AB, Maisonneuve P, Lankisch PG. Chronic pancreatitis and other risk factors for pancreatic cancer. Gastroenterol Clin North Am 1999, 28(3):673–685.
Whitcomb DC, Preston RA, Aston CE, et al. A gene for hereditary pancreatitis maps to chromosome 7q35. Gastroenterology 1996, 110(6):1975–1980.
Whitcomb DC, Gorry MC, Preston RA, et al. Hereditary pancreatitis is caused by a mutation in the cationic trypsinogen gene. Nat Genet 1996, 14(2):141–145.
Witt H, Luck W, Becker M. A signal peptide cleavage site mutation in the cationic trypsinogen gene is strongly associated with chronic pancreatitis. Gastroenterology 1999, 117:7–10.
Howes N, Greenhalf W, Stocken DD, et al. Cationic trypsinogen mutations and pancreatitis. Clin Lab Med 2005, 25(1):39–59.
Charnley RM. Hereditary pancreatitis. World J Gastroenterol 2003, 9(1):1–4.
Otsuki M. Chronic pancreatitis. The problems of diagnostic criteria. Pancreatology 2004, 4(1):28–41.
Whitcomb DC, Lowe ME. Pancreatitis: acute and chronic. In: Walker WA, Goulet O, Kleinman RE, et al. (eds.) Pediatric gastrointestinal disease: pathophysiology, diagnosis, management. Hamilton, ON: BC Decker, 2004, 1584–1597.
Whitcomb DC. Inflammation and cancer V. Chronic pancreatitis and pancreatic cancer. Am J Physiol Gastrointest Liver Physiol 2004, 287(2):G315–19.
Whitcomb DC. Clinical practice. Acute pancreatitis. N Engl J Med 2006, 354(20):2142–2150.
McElroy R, Christiansen PA. Hereditary pancreatitis in a kinship associated with portal vein thrombosis. Am J Med 1972, 52(2):228–241.
Shrikhande SV, Martignoni ME, Shrikhande M, et al. Comparison of histological features and inflammatory cell reaction in alcoholic, idiopathic and tropical chronic pancreatitis. Br J Surg 2003, 90 (12):1565–1572.
Etemad B, Whitcomb DC. Chronic pancreatitis: diagnosis, classification, and new genetic developments. Gastroenterology 2001, 120:682–707.
Axon AT, Classen M, Cotton PB, et al. Pancreatography in chronic pancreatitis: international definitions. Gut 1984, 25(10):1107–1112.
Sarles H.[Classification and definition of pancreatitis. Marseilles-Rome1988]. Gastroenterologie Clinique et Biologique 1989, 13(11):857–859.
Homma T, Harada H, Koizumi M. Diagnostic criteria for chronic pancreatitis by the Japan Pancreas Society. Pancreas 1997, 15(1):14–15.
The Criteria Committee for Chronic Pancreatitis of the Japan Pancreas Society. Clinical diagnostic criteria of chronic pancreatitis. (in Japanese). Suizo (Journal of the Japan Pancreas Society) 2001, 16:560–561.
Lowenfels AB, Maisonneuve P, Cavallini G, et al. Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group.[see comment] N Engl J Med 2003, 328(20):1433–1437.
Kattwinkel J, Lapey A, Di SAP, et al. Hereditary pancreatitis: three new kindreds and a critical review of the literature. Pediatrics 1973, 51(1):55–69.
Lowenfels A, Maisonneuve P, DiMagno E, et al. Hereditary pancreatitis and the risk of pan-creatic cancer. J Natl Cancer Inst 1997, 89(6):442–446.
Howes N, Wong T, Greenhalf W, et al. Pancreatic cancer risk in hereditary pancreatitis in Europe. Digestion 2000, 61:300.
Lee SK. [Hereditary pancreatitis]. Korean Journal of Gastroenterology/Taehan Sohwagi Hakhoe Chi 2005, 46(5):358–367.
Pitchumoni CS. Chronic pancreatitis: a historical and clinical sketch of the pancreas and pan-creatitis. Gastroenterologist 1998, 6(1):24–33.
Cohn JA, Friedman KJ, Noone PG, Knowles MR, Silverman LM, Jowell PS. Relation between mutations of the cystic fibrosis gene and idiopathic pancreatitis. N Engl J Med 1998, 339 (10):653–658.
Creighton J, Lyall R, Wilson DI, et al. Mutations of the cationic trypsinogen gene in patients with chronic pancreatitis [letter]. Lancet 1999, 354(9172):42–43.
Mack TM, Yu MC, Hanisch R, et al. Pancreas cancer and smoking, beverage consumption and past medical history. J Natl Cancer Inst 1986, 76:49–60.
Gold EB, Gordis L, Diener MD, et al. Diet and other risk factors for cancer of the pancreas. Cancer 1985, 55:460–467.
Farrow DC, Davis S. Risk of pancreatic cancer in relation to medical history and use of tobacco, alcohol and coffee. Intl J Cancer 1990, 45:816–820.
Jain M, Howe GR, St. Louis P, et al. Coffee and alcohol as determinants of risk of pancreatic cancer: a case-control study from Toronto. Intl J Cancer 1991, 47:384–389.
Kalapothaki V, Tzonou A, Hsieh CC, et al. Tobacco, ethanol, coffee, pancreatitis, diabetes mellitus, and cholelithiasis as risk factors for pancreatic carcinoma. Cancer Causes Control 1993, 4:1433–1437.
Whitcomb DC, Pogue-Geile K. Pancreatitis as a risk for pancreatic cancer. Gastroenterol Clin North Am 2002, 31(2):663–678.
Pitchumoni CS, Mohan V. Pancreatitis: juvenile tropical pancreatitis. In: Walker WA, Goulet O, Kleinman RE, et al. (eds.) Pediatric gastrointestinal disease: pathophysiology, diagnosis, management. Hamilton, ON, BC Decker, 2004, 1598–1605.
Pfützer RH, Barmada MM, Brunskil APJ, et al. SPINK1/PSTI polymorphisms act as disease modifiers in familial and idiopathic chronic pancreatitis. Gastroenterology 2000, 119:615–623.
Rossi L, Pfützer RL, Parvin S, et al. SPINK1/PSTI mutations are associated with tropical pancreatitis in Bangladesh: a preliminary report. Pancreatology 2001, 1(3):242–245.
Whitcomb DC. Genetic predispositions to acute and chronic pancreatitis. Med Clin North Am 2000, 84 (2):531–547.
Augustine P, Ramesh H. Is tropical pancreatitis premalignant. Am J Gastroenterol 1992, 87(8):1005–1008.
Chari ST, Mohan V, Pitchumoni CS, et al. Risk of pancreatic carcinoma in tropical calcifying pancreatitis: an epidemiologic study. Pancreas 1994, 9:62–66.
Whitcomb DC. Chronic pancreatitis and pancreatic cancer. Am J Physiol Gastrointest Liver Physiol 2004, 287:G315–G319.
Davis PB. Cystic fibrosis since1938. Am J Respir Crit Care Med 2006, 173(5):475–482.
Aronson BS, Marquis M. Care of the adult patient with cystic fibrosis. MEDSURG Nursing 2004, 13(3):143–154.
Sheldon CD, Hodson ME, Carpenter LM, et al. A cohort study of cystic fibrosis and malignancy. Br J Cancer 1993, 68(5):1025–1028.
Neglia JP, FitzSimmons SC, Maisonneuve P, et al. The risk of cancer among patients with cystic fibrosis. Cystic Fibrosis and Cancer Study Group. N Engl J Med 1995, 332(8):494–499.
Maisonneuve P, Lowenfels AB. Chronic pancreatitis and pancreatic cancer. Dig Dis 2002, 20(1):32–37.
Hruban RH, Adsay NV, Albores-Saavedra J, et al. Pancreatic intraepithelial neoplasia: a new nomenclature and classification system for pancreatic duct lesions. Am J Surg Pathol 2001, 25(5):579–586.
Hruban RH, Wilentz RE, Kern SE. Genetic progression in the pancreatic ducts. Am J Pathol 2000, 156(6):1821–1825.
Rozenblum E, Schutte M, Goggins M, et al. Tumor suppressive pathways in pancreatic carcinoma. Cancer Res 1997, (57):1731–1734.
Kern SE. Molecular genetic alteration in ductal pancreatic adenocarcinomas. In: Whitcomb DC, Cohn JA, UlrichII CD (eds.) Inherited diseases of the pancreas. Philadelphia, WB Saunders, 2000, 691–696.
Wilentz RE, Iacobuzio-Donahue CA, Argani P, et al. Loss of expression of Dpc4 in pancreatic intraepithelial neoplasia: evidence that DPC4 inactivation occurs late in neoplastic progression. Cancer Res 2000, 60:2002–2006.
Wong T, Howes N, Threadgold J, et al. Molecular diagnosis of early pancreatic ductal adeno-carcinoma in high-risk patients. Pancreatology 2001, 1(5):480–503.
Shi X, Friess H, Kleef J, et al. Pancreatic cancer: factors regulating tumor development, main-tenance and metastasis. Pancreatology 2001, 1(5):511–518.
Caldas C, Hahn SA, Da Costa L, et al. Frequent somatic mutations and homozygous deletion of the p16 (MTS1) gene in pancreatic adenocarcinoma. Nat Genet 1994, 8:27–32.
Hengstler JG, Bauer A, Wolf HK, et al. Mutation analysis of the cationic trypsinogen gene in patients with pancreatic cancer. Anticancer Res 2000, 20(5A):2967–2974.
Garcea G, Dennison AR, Steward WP, et al. Role of inflammation in pancreatic carcinogene-sis and the implications for future therapy. Pancreatology 2005, 5(6):514–529.
Adler G. Has the biology and treatment of pancreatic diseases evolved. Best Practice Res Clin Gastroenterol 2004, 18:83–90.
60. Marjolin J. Dictionnaire de Medecine, vol. 21 Pratique, 1828.
Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow. Lancet 2001, 357(9255):539–545.
Eslick GD, Lim LL, Byles JE, et al. Association of Helicobacter pylori infection with gastric carcinoma: a meta-analysis. Am J Gastroenterol 1999, 94(9):2373–2379.
Blaser MJ, Perez-Perez GI, Kleanthous H, et al. Infection with Helicobacter pylori strains possessing cagA is associated with an increased risk of developing adenocarcinoma of the stomach. Cancer Res 1995, 55(10):2111–2115.
Harris RE, Beebe-Donk J, Doss H, et al. Aspirin, ibuprofen, and other non-steroidal anti-inflammatory drugs in cancer prevention: a critical review of non-selective COX-2 blockade (review). [see comment] Oncol Rept 2005, 13(4):559–583.
Smith ER, Daly MB, Xu XX. A mechanism for cox-2 inhibitor anti-inflammatory activity in chemoprevention of epithelial cancers. Cancer Epidemiol Biomark Prev 2004, 13(1):144–145.
66. Hitt E. Aspirin may lower risk of pancreatic cancer. Lancet Oncol 2002, 3(9).
Kinzler KW, Vogelstein B. Landscaping the cancer terrain. Science 1998, 280(5366):1036–1037.
Farrow B, Evers BM. Inflammation and the development of pancreatic cancer. Surg Oncol 2002, 10(4):153–169.
Hedin KE. Chemokines: new, key players in the pathobiology of pancreatic cancer. Intl J Gastrointest Cancer 2002, 31(1-3):23–29.
Farrow B, Sugiyama Y, Chen A, et al. Inflammatory mechanisms contributing to pancreatic cancer development. Ann Surg 2004, 239(6):763–769.
Rayet B, Gelinas C. Aberrant rel/nfkb genes and activity in human cancer. Oncogene 1999, 18(49):6938–6947.
Albazaz R, Verbeke CS, Rahman SH, et al. Cyclooxygenase-2 expression associated with severity of PanIN lesions: a possible link between chronic pancreatitis and pancreatic cancer. Pancreatology 2005, 5(4-5):361–369.
Silverman DT, Dunn JA, Hoover RN, et al. Cigarette smoking and pancreas cancer: a case-control study based on direct interviews. J Natl Cancer Inst 1994, 86(20):1510–1516.
Applebaum-Shapiro SE, Finch R, Pfützer RH, et al. Hereditary pancreatitis in North America: The Pittsburgh-Midwest Multi-Center Pancreatic Study Group Study. Pancreatology 2001, 1 (5):439–443.
Hruban RH, Petersen GM, Goggins M, et al. Familial pancreatic cancer. Annals of Oncology 1999, 4:69–73.
Whitcomb DC, Ulrich II CD. Hereditary pancreatitis: new insights, new directions. Bailliere’s Clin Gastroenterol 1999, 13(2):253–263.
Goggins M, Schutte M, Lu J, et al. Germline BRCA2 gene mutations in patients with appar-ently sporadic pancreatic carcinomas. Cancer Res 1996, 56(23):5360–5364.
Anonymous. Cancer risks in BRCA2 mutation carriers. The Breast Cancer Linkage Consortium. J Natl Cancer Inst 1999, 91(15):1310–1316.
Park JG, Park YJ, Wijnen JT, et al. Gene-environment interaction in hereditary nonpolyposis colorectal cancer with implications for diagnosis and genetic testing. Intl J Cancer 1999, 82 (4):516–519.
Schenk M, Schwartz AG, O’Neal E, et al. Famlial risk of pancreatic cancer. J Natl Cancer Inst 2001, 93:640–644.
Lowenfels AB, Maisonneuve P, Whitcomb DC, et al. Cigarette smoking as a risk factor for pancreatic cancer in patients with hereditary pancreatitis. JAMA 2001, 286(2):169–170.
Malfertheiner P, Schutte K. Smoking—a trigger for chronic inflammation and cancer develop-ment in the pancreas. [comment] Am J Gastroenterol 2006, 101(1):160–162.
Maisonneuve P, Lowenfels AB, Mullhaupt B, et al. Cigarette smoking accelerates progression of alcoholic chronic pancreatitis. Gut 2005, 54(4):510–514.
Wittel UA, Pandey KK, Andrianifahanana M, et al. Chronic pancreatic inflammation induced by environmental tobacco smoke inhalation in rats. [see comment] Am J Gastroenterol 2006, 101 (1):148–159.
Kimsey TF, Campbell AS, Albo D, et al. Co-localization of macrophage inflammatory pro-tein-3alpha (Mip-3alpha) and its receptor, CCR6, promotes pancreatic cancer cell invasion. [erratum appears in Cancer J 2005, 11(4):354 Note: Wilson, M [added]]. Cancer J 2004, 10 (6):374-380.
Boyle P, Maisonneuve P, Bueno de Mesquita B, et al. Cigarette smoking and pancreas cancer: a case control study of the search programme of the IARC. Intl J Cancer 1996, 67(1):63–71.
Warshaw AL, Fernandez-del Castillo C. Pancreatic carcinoma. N Engl J Med 1992, 326 (7):455–465.
Bourliere M, Barthet M, Berthezene P, et al. Is tobacco a risk factor for chronic pancreatitis and alcoholic cirrhosis. Gut 1991, 32(11):1392–1395.
Lowenfels AB, Zwemer FL, Jhangiani S, et al. Pancreatitis in a native American Indian popu-lation. Pancreas 1987, 2(6):694–697.
Talamini G, Bassi C, Falconi M, et al. Alcohol and smoking as risk factors in chronic pancrea-titis and pancreatic cancer. Dig Dis Sci 1999, 44(7):1301–1311.
Hruban RH, Canto MI, Yeo CJ. Prevention of pancreatic cancer and strategies for manage-ment of familial pancreatic cancer. Dig Dis 2001, 19(1):76–84.
Finn OJ. Cancer vaccines: between the idea and the reality. Nat Rev Immunol 2003, 3(8):630–641.
Connolly EM, Osborne H, Hickey DP. A novel treatment for chronic pancreatitis. Irish J Med Sci 2003, 172(4):202–203.
Kekis PB, Friess H, Kleeff J, et al. Timing and extent of surgical intervention in patients from hereditary pancreatic cancer kindreds. Pancreatology 2001, 1(5):525–530.
Whitcomb DC, Ulrich DC, Learch MM, et al. Conference Report: Third International Symposium on Inherited Diseases of the Pancreas. Pancreatology 2001, 1(5):423–431.
Ulrich II CD. Pancreatic cancer in hereditary pancreatitis—Consensus guidelines for prevention, screening, and treatment. Pancreatology 2001, 1(5):416–422.
Khalid A, Pal R, Sasatomi E, et al. Use of microsatellite marker loss of heterozygosity in accurate diagnosis of pancreaticobiliary malignancy from brush cytology samples. Gut 2004, 53 (12):1860–1865.
Khalid A, McGrath KM, Zahid M, et al. The role of pancreatic cyst fluid molecular analysis in predicting cyst pathology.[see comment]. Clin Gastroenterol Hepatol 2005, 3(10):967–973.
Khalid A, Finkelstein S, McGrath K. Molecular diagnosis of solid and cystic lesions of the pancreas. Clin Lab Med 2005, 25(1):101–116.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer Science + Business Media, LLC
About this chapter
Cite this chapter
Greer, J.B., Zarnescu, N.O., Whitcomb, D.C. (2008). Hereditary Pancreatitis and Pancreatic Cancer. In: Lowy, A.M., Leach, S.D., Philip, P.A. (eds) Pancreatic Cancer. M. D. Anderson Solid Tumor Oncology Series. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-69252-4_6
Download citation
DOI: https://doi.org/10.1007/978-0-387-69252-4_6
Publisher Name: Springer, Boston, MA
Print ISBN: 978-0-387-69250-0
Online ISBN: 978-0-387-69252-4
eBook Packages: MedicineMedicine (R0)