Tamoxifen precipitation of familial hypertriglyceridaemia: a rare cause of acute pancreatitis

Wadood, Ali; Chesner, Robert; Mirza, Mehboob; Zaman, Shafquat

doi:10.1136/bcr-2016-214837

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…This mechanism has been reported as the cause of pancreatitis for everolimus 48 and tamoxifen. 49,[50][51][52] Everolimus causes elevated triglycerides in 30%-50% of patients. There are case reports and a review of tamoxifenassociated pancreatitis caused by elevated triglycerides.…”

Section: Proteosome Inhibitorsmentioning

confidence: 99%

Pancreatitis associated with newer classes of antineoplastic therapies

Clamon¹,

Patel²,

Mott³

2017

J Community Support Oncol

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Newer anticancer therapies including tyrosine kinase inhibitors, immune modulators, immunotherapies, and chemotherapies have been reported to cause acute pancreatitis. This review gathers data from multiple case reports and small case series that associate these agents with pancreatitis. The mechanism of the pancreatitis may be direct toxicity, elevated triglycerides, immune mediated, or injury with direct injection into the liver, pancreas, or its blood supply. As abdominal pain, nausea, vomiting are associated with cancer chemotherapy itself, the diagnosis of acute pancreatitis might be missed.

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Section: Proteosome Inhibitorsmentioning

confidence: 99%

Pancreatitis associated with newer classes of antineoplastic therapies

Clamon¹,

Patel²,

Mott³

2017

J Community Support Oncol

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“…DIP, a rare type of pancreatitis, is not commonly observed in the clinical practice. [ 3 ] It usually presents as AP rather than chronic pancreatitis, with a rapid onset and a short course. Clinically, it is generally similar to AP induced by other causes, and has no specific markers.…”

Section: Introductionmentioning

confidence: 99%

Acute pancreatitis induced by etoposide–lobaplatin combination chemotherapy used for the treatment of lung cancer

Cao

Duan²,

Zhang³

et al. 2017

Medicine

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Rationale:Drug-induced pancreatitis (DIP) is a rare type of pancreatitis that is not usually observed in the clinical practice. It is generally difficult to distinguish from acute pancreatitis (AP) induced by other causes.Patient concerns:Here, we report a 62-year-old Chinese female patient with “small cell lung cancer” as the initial presentation. Because the patient could not bear the surgical treatment, the chemotherapy composed of lobaplatin and etoposide was performed. Three days later, the patient displayed sudden abdominal pain, distension, nausea, and vomiting without obvious inducements. Laboratory tests showed that the levels of serum and urine amylase were enhanced; abdominal computed tomography (CT) result showed the enlargement of the pancreas, peripancreatic effusion, and a rough edge, which suggested the diagnosis of AP. The patient had no history of biliary tract disease, alcoholism, binge overeating, hyperlipidemia, and hereditary pancreatitis.Diagnoses:The patient was diagnosed with DIP.Interventions:The chemotherapy was stopped at once and we performed fluid resuscitation, pain alleviation, prophylactic antibiotics, and nutritional support, etc on the patient. Later, the patient's clinical symptoms were obviously relieved, and she recovered successfully.Outcomes:The chemotherapy was continued, but later, the patient showed abdominal pain, distension, nausea, and vomiting again. The levels of serum amylase and urine amylase were enhanced again. Further imaging examination strongly indicated the recurrence of AP.Lessons:We should raise awareness of the clinicians regarding DIP, thereby enabling its timely diagnosis and accurate treatment, as well as promoting the rational and safe use of drugs.

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“…It is a major public health concern owing to its significant potential mortality and morbidity, with an increasing rate of incidence and hospitalization [ 8 – 10 ]. In addition, several routinely prescribed drugs increase the risk of AP; medication use was reported as the cause of 0.1%– 5% of AP cases [ 11 , 12 ]. Increasing time trends were reported in a proportion of first-attack AP patients on pancreatitis-related drug therapy from 2003 to 2012 [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Tamoxifen use and acute pancreatitis: A population-based cohort study

et al. 2017

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BackgroundSeveral case reports have indicated that tamoxifen induced acute pancreatitis (AP); but no pharmacoepidemiological data support the claim. Therefore, we investigated whether tamoxifen use is correlated with the risk of AP in patients with breast cancer.MethodsThis population-based cohort study used the Taiwan National Health Insurance Research Database. A cohort of 22 005 patients aged ≥20 years with breast cancer from January 1, 2000 to December 31, 2009 was identified and the date of cancer diagnosis was set as the index date. The end point was developing AP during the follow-up. Hazard ratios (HRs) and 95% confidence intervals (CIs) were evaluated to determine the correlation between the risk of AP and tamoxifen use. Because the drug use varied over time, it was measured as a time-dependent covariate in the Cox proportional hazard model. The same approaches were applied in PS-matched cohorts.ResultsAfter adjustment for covariates and medication use including fluorouracil and doxorubicin, the risk of AP was not significant between tamoxifen users and tamoxifen nonusers (adjusted HR = 0.94, 95% CI = 0.74–1.19) in the non-matching cohorts. The results revealed no dose–response trend between tamoxifen use and the risk of AP (adjusted HR = 0.98, 95% CI = 0.96–1.00). The comorbidities DM and gallstones were associated with a significantly increased risk of AP. Similar trends were observed in PS-matched cohorts.ConclusionsNo significant correlation was observed between tamoxifen use and the risk of AP in patients with breast cancer.

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Tamoxifen precipitation of familial hypertriglyceridaemia: a rare cause of acute pancreatitis

Cited by 5 publications

References 8 publications

Pancreatitis associated with newer classes of antineoplastic therapies

Pancreatitis associated with newer classes of antineoplastic therapies

Acute pancreatitis induced by etoposide–lobaplatin combination chemotherapy used for the treatment of lung cancer

Tamoxifen use and acute pancreatitis: A population-based cohort study

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