Acute pancreatitis is a very rare comorbidity of acute ischemic stroke

Abstract

Background: Although acute pancreatitis is listed among the exclusion criteria for the administration of recombinant tissue plasminogen activator according to the Japanese Guideline for the Management of Stroke, the co-occurrence of acute pancreatitis and acute ischemic stroke has not been investigated. The present study aimed to assess the incidence rate of acute pancreatitis in patients with acute ischemic stroke.Methods: This study consecutively enrolled all patients with ischemic stroke admitted to the Department of Neurology, JA Toride Medical Center between April 2014 and March 2016. Diagnosis of acute pancreatitis was made according to the revised Atlanta Classification of Acute Pancreatitis. We retrospectively analyzed serum amylase activity and the frequency of acute pancreatitis as a comorbidity of ischemic stroke.Results: A total of 411 ischemic stroke patients were included. Serum amylase activity was measured for 364 patients, 27 of whom presented with amylase activity exceeding the upper limit of normal. In two patients with serum amylase activity greater than three times-fold the upper limit of normal, computed tomography or transabdominal ultrasonography showed no characteristic findings of acute pancreatitis. No patient in the cohort met the diagnostic criteria for acute pancreatitis.Conclusions: Acute pancreatitis is a very rare comorbidity of acute ischemic stroke.

Posterior reversible encephalopathy syndrome in a woman with pancreatitis

“…[3] In our previous review of the literature, we found no case report of acute pancreatitis in a retrospective study of 411 patients with acute ischemic stroke, whereas another study reported one cerebral hemorrhage patient with complications of pancreatitis. [4,5] The main differences from previously reported cases include following. First, except for pancreatitis, most of the previously reported patients had a history of leukemia or heavy drinking, but our case only had a history of pancreatitis.…”

Gastrointestinal Dysfunction in Stroke

“…However, chronic pancreatitis is associated with a 1.24-fold greater incidence of cerebrovascular disease (adjusted HR: 1.27; 95% CI: 1.19-1.36). 113 Bile acids aid in digestion and are produced in the liver and stored in the gallbladder. Charach et al discovered that bile acid excretion was higher among stroke survivors than in nonsurvivors, suggesting that impaired bile acid excretion is an independent risk factor for stroke, likely by preventing cholesterol excretion and contributing to subendothelial deposition.…”

“…However, chronic pancreatitis is associated with a 1.24-fold greater incidence of cerebrovascular disease (adjusted HR: 1.27; 95% CI: 1.19–1.36). 113…”

Hypertriglyceridemia may contribute to stroke and pancreatitis: A case report and review of the literature

“…However, very severe and extremely high triglyceride levels may not further increase the risk of stroke ( 4 ). It has been mentioned that the co-occurrence of stroke and acute pancreatitis due to hypertriglyceridemia is rare ( 5 ). This article detailed such a rare case and searched for similar case reports.…”