PROOF: Pancreatitis-associated Risk Of Organ Failure
PROOF: Pancreatitis-associated Risk Of Organ Failure
This is a prospective case control study that compares the initial immune response with
 severity and outcome in patients with acute pancreatitis.
This is a prospective case control study that compares the initial immune response with
 severity and outcome in patients with acute pancreatitis. Therefore, the investigators aim to
 determine whether etiology of acute pancreatitis, segregates with candidate genetic
 polymorphisms and their m-RNA expression, as well as whether functional polymorphisms in
 inflammation regulating genes predict a more severe outcome in acute pancreatits. The
 investigators anticipate that based on our results that we will provide a more accurate
 predictor of the clinical course of acute pancreatits and help direct more aggressive or
 cytokine specific treatment of patients at greater risk of a more severe form of the disease.
Inclusion Criteria:

 -  Inclusion criteria for Subjects (all three) Males and females of 16 years of age and
 older. Body weight at least 40kg

 Diagnosis of acute pancreatitis by both: Abdominal pain or abdominal localizing signs AND
 Elevated amylase levels by at-least three times the upper limit of normal and/or elevated
 lipase levels by at-least three times the upper limit of normal (25, 26). Acute
 pancreatitis must be defined by 2 of the 3 following criteria:

 -  Serum amylase or lipase elevated greater than 3X upper limit of normal

 -  epigastric acute pancreatitis pain

 -  abdominal imaging studies demonstrating pancreatic edema, peripancreatic fat stranding
 or complications or acute pancreatitis Willingness to participate in the study and
 sign the informed consent. (Children and subjects who are cognitively impaired for
 temporary reasons as mentioned in the section 4.7 of this protocol will require a
 representative to sign the informed consent).

 Inclusion criteria for Controls (all three) Males and females of 18 years of age and older.
 a. Unrelated family member or a friend of the subject or a patient having blood drawn in
 general medicine outpatient clinic, without a history of pancreatitis, OR Willingness to
 participate in the study and sign the informed consent.

 Additional Inclusion Criteria for subjects with a previous attack of acute pancreatitis:

 age criteria as defined above.

 - Previous severe attack of severe acute pancreatitis requiring a ICU stay of at least 48
 hours or evidence of pancreatic necrosis on computerized tomography.

 Willingness to participate and sign informed consent

 Exclusion Criteria:

 -  Exclusion Criteria for Subjects:

 Persons unwilling to sign the informed consent Disorientation secondary to irreversible
 organic brain damage. Mean corpuscular volume (MCV) of less than 77 in all children of 18
 years or younger.

 Blood transfusion within one week of enrollment Chronic Pancreatitis History of pancreatic
 cancer History of cancer requiring chemotherapy or radiation within the past 1 year History
 of organ transplant Subject is a prisoner Pancreatitis due to multiple trauma or surgical
 complications

 Exclusion criteria for Controls:

 Persons unwilling to sign the informed consent