Genetic factors are increasingly found as potential causes of children with acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP). Representative genes include cationic trypsinogen, serine protease 1 (PRSS1), serine protease inhibitor Kazal type 1 (SPINK1), cystic fibrosis transmembrane conductance regulator (CFTR), chymotrypsin C (CTRC) and calcium sensing receptor (CASR) genes, etc. In Korean children, PRSS1 and SPINK1 genes have been most commonly studied, while CFTR mutations were reported in one patient to date. We report a case of a 13-year-old male adolescent with CP with CFTR mutations. Since he was first diagnosed with idiopathic acute pancreatitis (IAP) based on laboratory and computed tomographic findings, he was admitted with ARP and CP over four times in a year at the secondary and tertiary hospital. No etiology was detected by several examinations including magnetic resonance cholangiopancreatography (MRCP), endosco-pic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography (EUS) with fine needle aspiration (FNA) biopsy and genetic test including PRSS1 and SPINK1. Although he had no typical symptoms associated with cystic fibrosis (CF), CFTR mutations were detected with additional gene examination. Testing for CFTR mutations should be concerned in pediatric patients with APR and CP without other identified causes.

There are reports that inhaling hypertonic saline with bronchodilator is helpful in the treatment of bronchiolitis. However, further studies are needed to determine if it is helpful to inhale hypertonic saline with bronchodilator in children with recurrent wheezing. We aimed to investigate the effect of hypertonic saline inhalation in children with recurrent wheezing. A total of 40 patients under 6 years of age admitted to Kwangju Christian Hospital from December 2014 to May 2016 were enrolled. Patients were randomly assigned to receive salbutamol. In the control group (n=21), salbutamol (2.5-5 mg / 0.5-1 mL) was inhaled four times a day with physiological saline (0.9% normal saline 1-3 mL). In the experimental group (n=19), the same amount of hypertonic saline (5% saline 1-3 mL) was inhaled four times a day instead of physiological saline. We compared the duration of wheezing remission between patients who had recurrent wheezing (n=40). There was no difference in the duration of wheezing remission in patients who had recurrent wheezing. But the hypertonic saline inhalation group had a lower post treatment clinical score on the 2nd-3rd day of admission than the physiological saline inhalation group. In this study, hypertonic saline inhalation therapy was not significantly effective in the treatment of recurrent wheezing. More additional research is needed to determine whether inhaled hypertonic saline is effective in the treatment of recurrent wheezing.