Drug-induced pancreatitis: A rare manifestation of doxycycline administration

Abstract

Context:Drug-induced pancreatitis (DIP) is rare, but as there are no systematic data on it, the true incidence is not known. Although numerous and varied drugs have been associated with DIP, the clinical evidence on doxycycline-induced pancreatitis is sparse.Case Report:We present the case of a 58-year-old female who presented with complaints of nausea and severe epigastric pain. Her medications included doxycycline which she had been on for only 2 days. Computed tomography of her abdomen showed mild enlargement of body of the pancreas with peripancreatic fatty infiltration, along with lipase level suggestive of acute pancreatitis. In the absence of classical risk factors for acute pancreatitis, a diagnosis of DIP secondary to doxycycline therapy was made. Immediate withdrawal of the drug was accompanied by relief of symptoms and resolution of pancreatitis.Conclusion:This report implicates doxycycline as an etiological factor for acute pancreatitis. Knowledge regarding doxycycline related pancreatitis is of paramount importance in order to diagnose cases early and institute effective treatment in patients who are undergoing therapy with this drug.

Hypertriglyceridemic Pancreatitis: Is Insulin Monotherapy A Feasible Therapeutic Option?

“…It is considered a relatively uncommon etiology of acute pancreatitis after gallstones and alcohol abuse [1]. Hypercalcemia, iatrogenic injuries in procedures like endoscopic retrograde cholangiopancreatography (ERCP), genetic mutations, drugs, infections, toxins, trauma, abdominal surgery, malignancy, and idiopathic are included among the less common causes [2-3]. According to one estimate, hypertriglyceridemia accounts for up to 10% of all the pancreatitis episodes while in pregnant patients, it may lead to pancreatitis in more than 50% of all cases [4].…”

Doxycycline-Induced Acute Pancreatitis: A Rare Adverse Event

“…The study from the Czech Republic in 2010 reported that among 170 cases of acute pancreatitis, 5.3% were DIP [ 4 ]. Thus, the exact incidence of DIP is very hard to determine, and of this, doxycycline to be reported as a causative drug has been exceedingly rare [ 6 ]. A PubMed search which was performed using the MeSH terms “Doxycycline” AND “Pancreatitis” shortlisted just two case reports reporting definite DIAP [ 6 , 7 ].…”

“…Thus, the exact incidence of DIP is very hard to determine, and of this, doxycycline to be reported as a causative drug has been exceedingly rare [ 6 ]. A PubMed search which was performed using the MeSH terms “Doxycycline” AND “Pancreatitis” shortlisted just two case reports reporting definite DIAP [ 6 , 7 ]. There were two other case reports reporting probable DIAP [ 8 , 9 ].…”

“…The mechanism by which it causes pancreatitis is largely unknown. However, because of the rarity, it may be considered as an idiosyncratic reaction [ 6 ].…”

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

“…AP is often induced by biliary tract disease, alcoholism, excessive eating and drinking, and trauma, etc. [ 1 , 2 ] Recently, the clinical incidence of drug-induced pancreatitis (DIP) has gradually increased owing to the extensive use of medications. DIP, a rare type of pancreatitis, is not commonly observed in the clinical practice.…”