Analysis of 1060 Cases of Drug-Induced Acute Pancreatitis

Meczker, Ágnes; Hanák, Lilla; Párniczky, Andrea; Szentesi, Andrea; Erőss, Bálint; Hegyi, Péter; Erdősi, Dalma; Zs, Szakács; Dobszai, Dalma; Szekeres, L.; Bajor, Judit; Mikó, Alexandra; Vincze, Áron; Matuz, M; Csupor, Dezső; Pethő, Gábor; Pál, Heim

doi:10.1053/j.gastro.2020.07.016

Cited by 31 publications

(22 citation statements)

References 26 publications

(15 reference statements)

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“…Both of our cases ended up in recovery; however, DIAP seems more severe than that of the AP of other etiology (severe cases accounted for 19.56 vs. 5.63%, respectively; and mortality accounted for 7.66 vs. 2.25%, respectively) [27].…”

Section: Discussionmentioning

confidence: 48%

“…Patients were young with age ranging from 19 to 47 years. In general, DIAP cases are younger than AP from other etiologies (supported by our data from the Hungarian AP Registry) [27]. Unfortunately, these reports were not detailed enough to establish the disease course of DIAP, except in one article [12], which describes a similar case where 1-year 5-ASA treatment was followed by an episode of AZA triggered mild DIAP.…”

Section: Discussionmentioning

confidence: 56%

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Recurrent acute pancreatitis induced by 5-ASA and azathioprine in ulcerative colitis

et al. 2020

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 56%

Recurrent acute pancreatitis induced by 5-ASA and azathioprine in ulcerative colitis

et al. 2020

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“…Although drug-related causes of acute pancreatitis are rare overall (0.1–2%), numerous drugs have been reported to cause acute pancreatitis [ 8 – 11 ]. As most of the knowledge of DIAP comes from case reports and case series, the actual incidence may be higher [ 9 , 12 ]. Among the most common are analgesics and antiinflammatory medications, accounting for approximately 30%, followed by antimicrobials and cardiovascular and immunomodulatory drugs (mainly azathioprine and 6-mercaptopurine) [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Drug-induced acute pancreatitis in a bodybuilder: a case report

Shabestari

Chaudhary

et al. 2022

J Med Case Reports

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Background Unregulated use of a variety of drugs and supplements by bodybuilders and athletes is common and can lead to severe adverse complications. Only a small proportion of acute pancreatitis cases are drug induced, and case reports are essential for identifying potential drug-related risks for pancreatitis. Here we present the first case report published of acute pancreatitis linked to recreational use of anabolic–androgenic steroids, subcutaneous growth hormone, and clenbuterol in a previously healthy male after excluding all other causes of pancreatitis. Case presentation A 31-year-old Arab male bodybuilder presented with acute abdominal pain associated with nausea and sharp pain radiating to the back. The patient was not using tobacco or alcohol but was using multiple drugs related to bodybuilding, including anabolic–androgenic steroids, subcutaneous growth hormone, clenbuterol, and multiple vitamin supplements. Laboratory studies revealed a normal white blood cell count, elevated C-reactive protein, minimally elevated aspartate aminotransferase and total bilirubin with normal remaining liver tests, and elevated amylase and lipase. The patient had no hypertriglyceridemia or hypercalcemia, and had had no recent infections, abdominal procedures, trauma, or scorpion exposure. Imaging and laboratory investigations were negative for biliary disease and IgG4 disease. Abdominal computed tomography revealed hepatomegaly and diffuse thickening and edema of the body and tail of the pancreas with peripancreatic fat stranding. An abdominal ultrasound showed slight hepatomegaly with no evidence of cholelithiasis. Genetic testing for hereditary pancreatitis-related mutations was negative. A diagnosis of drug-induced acute pancreatitis was made, and he was treated with aggressive intravenous hydration and pain management. The patient has avoided further use of these drugs and supplements and had no further episodes of pancreatitis during 1 year of follow-up. Conclusions This case describes a patient with drug-induced acute pancreatitis after the intake of anabolic–androgenic steroids, subcutaneous growth hormone, and clenbuterol, where all other common causes of acute pancreatitis were excluded. Clinicians should be alert to the possibility of drug-induced acute pancreatitis occurring in bodybuilders and athletes using similar drug combinations.

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“…AP can also occur due to drugs at a rate of 0.1-0.5% [2,[23][24][25]. Many drugs have been identified that cause acute pancreatitis.…”

Section: Etiologymentioning

confidence: 99%

Emergency Management of Acute Pancreatitis

Karaali¹,

Topal²

2022

Recent Advances in Pancreatitis

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Acute pancreatitis (AP) is the sudden inflammation of the pancreas, and it may be confined to the pancreas, or more life-threatening, affecting all organs and systems. AP is a common gastrointestinal condition Worldwide and is associated with cost to the health care system. It progresses mildly in 80% of patients and resolves with treatment, but in cases of severe AP, with mortality of around 30% recorded. In this section, we will discuss the first management of the AP in the emergency department. Because this is the period when management decisions can change the course of the disease and the length of stay in the hospital. In the management AP, approaches regarding the utility and timing of antibiotics, the timing and type of nutritional support, endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy approaches are constantly being updated. Treatment is mainly related to the severity of the disease. With early diagnosis and treatment, most of the patients can be discharged, and the development of complications and mortality can be reduced. Therefore, emergency management is important in acute pancreatitis.

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Analysis of 1060 Cases of Drug-Induced Acute Pancreatitis

Cited by 31 publications

References 26 publications

Recurrent acute pancreatitis induced by 5-ASA and azathioprine in ulcerative colitis

Recurrent acute pancreatitis induced by 5-ASA and azathioprine in ulcerative colitis

Drug-induced acute pancreatitis in a bodybuilder: a case report

Emergency Management of Acute Pancreatitis

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