Acute Pancreatitis Associated With the Measles Virus

Abstract

Acute pancreatitis is an inflammatory condition which typically presents with abdominal pain, and is one of the most complex and challenging of all acute abdominal disorders. Its clinical manifestations are as numerous and diverse as its etiology. Rare complications of measles virus infection include acute appendicitis with perforation and peritonitis, mesenteric lymphadenitis, hepatitis, ileocolitis, cervicitis and acuteglomerulonephritis. 1,2 Only two cases have been reported in the literature that were caused by the measles virus, while another case was caused by the measles, mumps and rubella vaccine. Case Report A 16-year-old female was admitted to Whammed General Hospital in August 1997, with fever of five days' duration, which was associated with dry cough, a burning sensation in the eyes, and running nose. A reddish skin rash appeared on the fourth day of her illness, starting on the face, and then spreading to the trunk and extremities. On the day of admission, the patient started to complain of severe epigastric pain radiating to the back, and associated with repeated vomiting. The patient gave no history of any recent drug intake. According to the parents, the patient had not received the measles vaccination during her childhood, and had had a recent contact with a patient who had measles. On examination, the patient looked ill and flushed in the face, with a temperature of 38.6°C, pulse rate of 130/minute regular, and blood pressure of 145/75 mm Hg. She had red conjunctiva, Koplik's spots on the buccal mucosa, and a congested throat. Maculopapular rashes covered the face, around the ears, the trunk and the extremities. There was epigastric tenderness on abdominal examination, but no palpable mass. Laboratory investigations showed hemoglobin of 145 g/L, WBC 4.5X10 9 /L, platelets 159X10 9 /L, all of which were within normal limits. As well, kidney function tests, liver function tests, arterial blood gases, serum cholesterol, triglycerides and serum calcium were all normal. Chest x-ray, abdominal CT scan and sonography were normal. Hepatitis viral serology for A, B, and C, and human immunodeficiency virus (HIV) were negative, as well as blood cultures. Virology studies showed Epstein-Barr virus-Caspid IgG antibodies as positive, EBV-Caspid IgM antibodies as negative,EBVnuclearantigenas-ABpositive,andEBV early antigen as negative. These results were suggestive of previous EBV exposure. Enterovirus (IgM ELISA) total antibodies by CFT16 were negative, mumps IgM and IgG were negative, but measles (EIA) IgM was positive.

Clinical peculiarities of measles in children from the Ternopil region, Ukraine

“…Also, digestive system complications were present, such as gastroenteritis, stomatitis, hepatitis, pancreatitis, and acute appendicitis. The same complications were described by many other authors [4,6,8,11,12,15,19,20]. Neurological complications in our patients included one case of encephalitis and febrile seizures in three patients (1.0%); the same complicated course was described in the literature [4-6, 8, 21, 22].…”

Current course of measles in adults (a literature review)

“…In the literature, there are a few reports of pancreatic lesion. According to [37], pancreatitis was observed in 1.1 % of patients, and according to [32] -in 2.5 % of adult patients with measles. There is report of Mexican scientists about gastrointestinal complication such as upper gastrointestinal bleeding in 13 % of measles patients [36].…”

Pathology of exocrine part of pancreas in new coronavirus infection COVID-19

“…Пандемия новой коронавирусной инфекции COVID-19 выдвигает SARS-CoV-2 на первое место среди других вирусных инфекций, ранее рассматриваемых в качестве вероятных инфекционных факторов идиопатического панкреатита, в частности вируса гепатита, вируса Коксаки и другие [39][40][41][42][43][44][45][46][47][48].…”