Acute necrotising pancreatitis derived from low-dose corticosteroid use: an important reminder of clinical management

Sabre, Alexander; Guthrie, Morgan Mary; Maleknia, Reza

doi:10.1136/bcr-2015-209325

Cited by 10 publications

(5 citation statements)

References 5 publications

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“…Our patient took metoprolol for three years without adverse events and during her entire hospitalization, including the time of pancreatic enzyme level normalization and symptomatic improvement. Few cases reported pantoprazole [46,47] and methylprednisolone [48][49][50][51][52][53][54] induced AP, but in our patient, these drugs were continued throughout the hospital stay as well. Parallel to the rechallenge, our patient's diet was advanced, which could cause recurrence of AP.…”

Section: Discussionmentioning

confidence: 59%

5-ASA Induces Mild Acute Pancreatitis. Case Report and Review of the Literature

Meczker

Mikó

Hegyi

2018

JGLD

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5-aminosalicylic acid has been reported to be able of inducing acute pancreatitis as an adverse reaction. However, in most case reports, rechallenge of the drug is missing; therefore, evidence is still needed to confirm its role in the clinical course of acute pancreatitis and its influence on the outcome. Here, we report a case of recurrent acute pancreatitis secondary to 5-aminosalicylic acid, with positive unintentional rechallenge. A systematic search of the literature was performed and 42 cases from 35 articles were summarized concerning the clinical course of 5-aminosalicylic acid induced acute pancreatitis.

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Section: Discussionmentioning

confidence: 59%

5-ASA Induces Mild Acute Pancreatitis. Case Report and Review of the Literature

Meczker

Mikó

Hegyi

2018

JGLD

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“…Whether the present case or the intra-articular injection case share a cause-and-effect relationship between the steroids and the pancreatitis is only speculative, but some elements are clear. First, glucocorticoids, even in small doses, are a commonly known risk factor for pancreatitis [9,13]. Second, the literature shows the risk for development of pancreatitis after taking oral steroids is highest 4-14 days after the medication is taken [13].…”

Section: Discussionmentioning

confidence: 99%

“…Less than 5% of cases are secondary to drug-induced adverse effects [8]. Pancreatitis has been reported to be associated with steroid medication use, even in cases in which the steroid dosages would be considered too low to suppress the HPA axis [9]. Here, we report a case of transient glucocorticoid-induced pancreatitis that occurred 1 week after lumbar epidural steroid injection.…”

Section: Introductionmentioning

confidence: 86%

Epidural Steroid Injection-Induced Pancreatitis: A Case Report

et al. 2020

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Rare co-existance of disease or pathology Background:Degenerative disc disease of the lumbar spine can be associated with spinal canal and neuroforaminal stenosis, resulting in severe pain. Conservative approaches to treatment are generally recommended initially, especially in the elderly. Epidural corticosteroid injections can provide significant but temporary pain relief and are a commonly performed procedure in pain management. Pancreatitis caused by corticosteroids is unusual and the prognosis typically is good. Case Report:A 73-year-old woman presented with severe intractable back pain 1 week after lumbar epidural steroid injection for symptomatic spinal stenosis. Imaging confirmed severe multi-level degenerative disc disease of the lumbar spine resulting in severe canal and bilateral neuroforaminal stenosis. Because of abdominal pain and nausea, an abdominal CT and labs were performed, revealing evidence of pancreatic inflammation. Conclusions:Lumbar epidural steroid injection may be a risk factor for developing steroid-induced pancreatitis.

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“…Whether subgroups exist and how they should possibly influence recommendations on the dosage, treatment initiation and duration needs further investigation. When considering corticosteroid dosage and treatment duration, practitioners should keep in mind that studies have found evidence of corticosteroids causing or increasing the risk of acute pancreatitis [ 21 , 22 ].…”

Section: Limitationsmentioning

confidence: 99%

“…Corticosteroids are generally contraindicated because of the risk of gastric ulcerations and reduced reticuloendothelial activity [ 19 ]. Recent human case studies have indicated that corticosteroids may even induce acute pancreatitis [ 21 , 22 ]. In dogs with hyperadrenocorticism, one study reported increases in canine pancreatic-specific lipase (Spec-cPL) concentrations without any obvious clinical evidence of pancreatitis [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Corticosteroid treatment for acute/acute-on-chronic experimental and naturally occurring pancreatitis in several species: a scoping review to inform possible use in dogs

Bjørnkjær-Nielsen

Bjørnvad

2021

Acta Vet Scand

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Acute pancreatitis in dogs is a prevalent disease characterised by mild to severe inflammation. Treatment with anti-inflammatory corticosteroids has been widely debated but is not generally recommended in veterinary medicine. The objective of the present study was to present current evidence on the effect of corticosteroid treatment for acute/acute-on-chronic pancreatitis across species. These findings were then used to evaluate if and how corticosteroid treatment could influence disease outcome in canine acute/acute-on-chronic pancreatitis. A scoping review was performed by searching the Agricola, CAB Abstracts, MEDLINE and Embase databases to identify relevant articles published before June 24, 2021. The inclusion criteria were English language, original research published in a peer-reviewed journal, and investigation of corticosteroid treatment effects on acute/acute-on-chronic pancreatitis by the outcome parameters clinical score, circulating CRP level, hospitalisation duration, mortality and pancreas histopathology. Research on any species was considered. Studies were rated based on the level of evidence, and methodological quality was evaluated based on similarity between groups at baseline, risk of bias and study group size. The reporting method was based on the PRISMA extension for scoping reviews. One thousand nine hundred fifty-four studies were identified, and 31 met the inclusion criteria. Five were canine studies, with 4 investigating experimentally induced pancreatitis; 5 were human clinical studies; and 21 were rodent studies of experimentally induced pancreatitis. The level of evidence ranged between randomised controlled trials and case series, the estimated risk of bias ranged from low to high, and the sample sizes ranged from very small to moderate. Evidence indicates that adding corticosteroid to symptomatic treatment of acute/acute-on-chronic canine pancreatitis could have a positive influence on disease outcome. However, the analysed evidence was based on several species, including both naturally occurring and experimentally induced pancreatitis; thus, the authors suggest that large randomised controlled studies should be performed in dogs with spontaneously occurring acute/acute-on-chronic pancreatitis to further elucidate a potential benefit of corticosteroid treatment.

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Acute necrotising pancreatitis derived from low-dose corticosteroid use: an important reminder of clinical management

Cited by 10 publications

References 5 publications

5-ASA Induces Mild Acute Pancreatitis. Case Report and Review of the Literature

5-ASA Induces Mild Acute Pancreatitis. Case Report and Review of the Literature

Epidural Steroid Injection-Induced Pancreatitis: A Case Report

Corticosteroid treatment for acute/acute-on-chronic experimental and naturally occurring pancreatitis in several species: a scoping review to inform possible use in dogs

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