Sulfonamide-Induced Pancreatitis

A Swedish case-control network for studies of drug-induced morbidity – acute pancreatitis

“…An immune-mediated mechanism has been suggested for sulphonamides since acute pancreatitis develops rapidly after re-exposure. In some cases, a positive lymphocyte transformation test accompanied by rash or fever has been seen [31]. In our study there was a statistically significant OR for antibacterials as a group [OR 1.9 (1.1-3.2)].…”

“…Several reports concerning acute pancreatitis associated with different antibiotics exist [6,22,23,24,25,26,27,28,29,30,31,32]. In an experimental study, tetracycline was shown to cause pancreatitis by impairing pancreatic protein synthesis and secretion [25].…”

“…Other antibiotics, e.g. erythromycin and sulphonamides [27,28,29,30,31,32], have been identified as possibly causing acute pancreatitis. Erythromycin stimulates contractions of the gastrointestinal tract and gallbladder [28] and may increase the pressure of the sphincter of Oddi [27].…”

A Rare Cause of Drug-Induced Acute Pancreatitis: Sulfasalazine

“…There are reported cases about the relationship between sulfonamides and AP. Sulfamethoxazole and sulfapyridine are the two major sulfonamides shown to cause drug-induced pancreatitis (Brazer & Medoff, 1988). Mesalamine, which is a pure 5-ASA derivative, has also been associated with pancreatitis (Fernández et al, 1997).…”

Drug-Induced Acute Pancreatitis After Long-Term Sulfasalazine Therapy

“…There have been some case reports about the association of sulfonamides with AP. Among sulfonamides, sulfamethoxazole and sulfapyridine have been most associated with pancreatitis [14,15]. Pure 5-ASA derivative mesalamine (a 5-ASA moiety alone without any sulfa molecule) has also been associated with pancreatitis [16].…”