SPINK1 and chronic pancreatitis: Chronic pancreatitis caused by CFTR is inherited in an autosomal recessive or complex manner due to compound heterozygosity for CFTR or a combination of defects in CFTR and other genes.22 Cationic trypsinogen mutation (PRSS1) generally does not require added risk factors, but others like SPINK1 and CFTR are considered disease modifiers and require additional factors for manifestation.23 The risk factors identified in these children are abdominal trauma, hypertriglyceridemia, and familial pattern.