Angiotensin-Converting Enzyme (ACE) Inhibitors and Pancreatitis: A Potential Dose-dependent Relationship

Hussain, Murtaza; Deliwala, Smit; Ponnapalli, Anoosha; Modi, Viraj; Kanugula, Ashok Kumar; Elbedawi, Mamoon; Bachuwa, Ghassan

doi:10.12890/2020_001956

Cited by 6 publications

(2 citation statements)

References 19 publications

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“…Additionally, it has been proposed that angiotensin II receptors contribute to pancreatic secretion and microcirculation, which may increase vascular permeability leading to angioedema and ductal obstruction. Furthermore, ACE-I has been known to cause hypoglycemia, which may contribute to causing AP via direct toxic effects on the pancreatic ducts [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

A Fatal Case of Lisinopril-Induced Acute Necrotizing Pancreatitis

Masarweh¹,

Al-Moussally²,

Garron³

et al. 2023

Cureus

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Angiotensin-converting enzyme inhibitors (ACE-I), such as lisinopril, are used as first-line therapy in the treatment of hypertension, heart failure with reduced ejection fraction, and proteinuric chronic kidney disease due to their beneficial effects on reducing morbidity and mortality. Commonly cited adverse effects of lisinopril include hyperkalemia, acute kidney injury, and angioedema, and while uncommon, there have been reports of lisinopril-induced necrotizing pancreatitis in the literature. The true incidence of drug-induced pancreatitis is unknown since establishing a causal relationship between medication’s adverse effects and disease occurrence is difficult; however, there are validated tools such as the Adverse Drug Reaction Probability Scale that can aid in determining causality. Here, we present a case of a 63-year-old man with a history of hypertension who was being treated with lisinopril for eight months and developed a fatal case of lisinopril-induced severe necrotizing pancreatitis.

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Section: Discussionmentioning

confidence: 99%

A Fatal Case of Lisinopril-Induced Acute Necrotizing Pancreatitis

Masarweh¹,

Al-Moussally²,

Garron³

et al. 2023

Cureus

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“…Of the common drugs associated with AP, ACE inhibitors have an even lower incidence of causality [5][6][7][8][9][10][11]. They are generally safe and have excellent tolerability with a low risk for adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Another Case of Lisinopril-Induced Acute Pancreatitis

Baum¹,

Walfish²,

Fenster³

et al. 2021

Cureus

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Lisinopril as a cause for acute drug-induced pancreatitis is an emerging phenomenon that due to its generally low-risk profile often goes unnoticed. The true incidence of drug-induced pancreatitis is unknown, probably because of its nonrecognition among differential diagnosis. Only a handful of lisinopril-induced pancreatitis has been discussed in the literature, and little epidemiological evidence exists to establish true causality. Additionally, many of these reports have been met with skepticism claiming that it is difficult to isolate a true cause since many of these patients had comorbidities or were concomitantly taking other medications that may have contributed to the pancreatitis. Here, we report a case in which a generally otherwise healthy patient presented with acute drug-induced pancreatitis caused by an angiotensin-converting enzyme (ACE) inhibitor taken eight weeks prior to the onset of symptoms. The drug was immediately stopped, and the patient recovered well, with no complications.

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