What was amazing is that unexpected variants were found in these patients including a copy number variant of the PRSS1 gene in one patient, a rare SPINK1 mutation that had only been described in two French patients in early 2004 (Le Marechal et al., 2004), a strong effect of smoking, and a CFTR variant that is considered mild variable may be associated with pancreatitis disease (Larusch et al., 2012). Here, SPINK1 is linked to pancreatitis.