Analysis of clinical characteristics of tigecycline‐induced acute pancreatitis

Abstract

What is known and Objective The purpose of this study is to explore the clinical characteristics of tigecycline‐induced acute pancreatitis. Methods We searched the PubMed/Medline, Web of Knowledge, OVID, Elsevier, Springer Link, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Chinese VIP databases from 2005 and identified 19 studies of tigecycline‐induced acute pancreatitis involving a total of 22 patients for inclusion in a retrospective analysis. Results and Discussion The median (range) age of 22 patients with acute pancreatitis was 58 years (range 9‐83). Overall, the median (range) time of symptom onset was 6.5 days (range 2‐28), or 6 days (range 2‐14) and 6 days (range 3‐28) in patients with or without a loading dose of tigecycline, respectively. Symptoms included nausea, vomiting and abdominal distension (73%) and abdominal pain (73%); 90% (18/20) of patients developed mild acute pancreatitis (MAP), and 10% (2/20) developed severe acute pancreatitis (SAP). Computed tomography (CT) scans showed oedematous infiltrate in 56% (10/18) of cases and acute pancreatitis in 28% (5/18) of cases. The median (range) level of lipase and amylase was 936U/L (range 382‐4089) and 588U/L (range 312‐1166), respectively. The median (range) time to recovery of symptoms was 4 days (range 1‐10), and the time for recovery of pancreatic enzymes to the normal range was 5 days (range 1‐30) after the withdrawal of tigecycline in all patients. What is new and Conclusion Clinicians should be particularly mindful of clinical signs and symptoms, the level of serum pancreatic enzymes and abdominal CT images in order to monitor the development of pancreatitis when using tigecycline.

Clinical characteristics and risk factors for tigecycline-induced pancreatitis in a tertiary hospital: a retrospective study

“…16 In our patients, abdominal symptoms were relieved at a mean of 3.6 days after tigecycline withdrawal and the enzyme levels returned to their normal ranges at a mean of 7.1 days, similar to the findings in a previous study (4 days and 5 days, respectively). 15 We also noted that five patients had no obvious symptoms, consistent with the previous study. 15 The possible reasons for TIP may be the high elimination rate of tigecycline by the biliary tract 17 and the similar mechanism to tetracycline-induced pancreatitis (reaction with 30S ribosomal units and blockade of protein synthesis leading to triglyceride accumulation in the pancreas).…”

“…15 We also noted that five patients had no obvious symptoms, consistent with the previous study. 15 The possible reasons for TIP may be the high elimination rate of tigecycline by the biliary tract 17 and the similar mechanism to tetracycline-induced pancreatitis (reaction with 30S ribosomal units and blockade of protein synthesis leading to triglyceride accumulation in the pancreas). 18 The mean Naranjo score in our patients was 7.2.…”

“…Our results were similar to those of a secondary analysis involving 19 studies on tigecycline-induced AP, in which edematous infiltrate was the main imaging feature in patients and most cases had mild AP. 15 We further found that the mean time from tigecycline use to symptom onset was 7.2 days, while previous studies reported 8.5 days 14 and 12.5 days. 16 In our patients, abdominal symptoms were relieved at a mean of 3.6 days after tigecycline withdrawal and the enzyme levels returned to their normal ranges at a mean of 7.1 days, similar to the findings in a previous study (4 days and 5 days, respectively).…”

CT findings of chemotherapy drug-related acute pancreatitis

“…In addition, acute necrotic collections (necrotizing pancreatitis) and main pancreatic duct dilatation were not observed, and normal pancreas morphology existed in our CT cohort, which implies that CDRAP mainly showed an interstitial edematous pancreatitis and/or a normal pancreas shape. In addition, this nding is consistent with Fang W's study [22]. However, ICI-associated pancreatitis has a heavier pancreas than CDRAP, which usually shows necrotizing pancreatitis when necrosis is present on imaging results [25].…”

“…However, chemotherapy-related adverse events are common in clinical work, such as bone marrow suppression, gastrointestinal symptoms, and neurotoxicity [20]. Drug-induced acute pancreatitis is one such rare adverse effect of chemotherapy and is di cult to diagnose, roughly accounting for 5% of acute pancreatitis [21,22]. In this paper, we retrospectively studied the CT imaging features of combination chemotherapy-related acute pancreatitis.…”