Incidence, Severity, and Etiology of Drug-Induced Acute Pancreatitis

Vinklerová, Ilona; Procházka, Michal; Procházka, Vladimír; Urbánek, Karel

doi:10.1007/s10620-010-1277-3

Cited by 101 publications

(88 citation statements)

References 20 publications

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“…Drug-induced pancreatitises are a rare cause of pancreatitis which represents about 3-5% of all causes (3,4), but it is difficult to establish its real incidence because of the lack of prospective studies and the underdiagnosis of this entity. They are more frequent in young patients, women and Crohn's disease (3), the latter being probably related with the drugs taken for the disease.…”

Section: Discussionmentioning

confidence: 99%

“…They are more frequent in young patients, women and Crohn's disease (3), the latter being probably related with the drugs taken for the disease. It represents a diagnostic challenge since quite often the drug is not related to the episode of pancreatitis, which is finally catalogued as an idiopathic pancreatitis (3,4). This difficulty derives from the fact that they are not usually considered in the initial differential diagnosis, and establishing its relationship with the origin of the pancreatitis is difficult.…”

Section: Discussionmentioning

confidence: 99%

“…It presents like any other pancreatitis with abdominal epigastric pain radiating to the back and amylase above three times its normal value (3,7,9). It is not usually accompanied by rash, lymphadenopathy and/or eosinophilia, as other diseases caused by toxins (5).…”

Section: Discussionmentioning

confidence: 99%

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Case of drug-induced acute pancreatitis produced by horsetail infusions

et al. 2017

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Introduction:The most frequent causes of acute pancreatitis are biliary stones, alcohol consumption, smoking and tumors. Some of them do not have any established cause, and they are catalogued as idiopathic pancreatitis.Case report: We report the case of a 56-year-old woman with a history of bilateral adrenalectomy on hormone replacement therapy with corticosteroids, who has recurrent episodes of mild acute pancreatitis with an etiologic study (laboratory and imaging tests) without significant findings. A drug-induced etiology was suspected, so corticosteroids were removed and antihypertensive treatment was modified, but the clinical manifestations persisted. Later regular consumption of horsetail infusions was detected, and after their suspension the patient became asymptomatic and has not presented new episodes.Discussion: The drug-induced acute pancreatitis is a strange cause of pancreatitis that is frequently underdiagnosed because of the difficulty to establish a relationship between the drugs and the pancreatitis. Lots of drugs have been related with acute pancreatitis, while the information available for herbal products is limited. They usually present like mild and recurrent episodes, without significant findings in both laboratory and imaging tests (abdominal ultrasound, abdominal computed tomography [CT], cholangiography and endoscopic ultrasound). It is important to detect the origin of this type of pancreatitis to prevent recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Case of drug-induced acute pancreatitis produced by horsetail infusions

et al. 2017

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“…A national survey performed in Japan in 1999 reported that 1.2% of all cases of AP were drug induced. Drug-induced AP is rare but should not be overlooked in a patient who presents with idiopathic AP [6]- [8].…”

Section: Discussionmentioning

confidence: 99%

Primary Isolated Case of Drug Induced Pancreatitis Misdiagnosed as Idiopathic Pancreatitis

Ghani¹,

Saba²,

Hussain³

et al. 2014

CRCM

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Drug Induced Pancreatitis is a very common cause of acute pancreatitis in older patients and is often treated by just symptomatic treatment. An old hypertensive lady was admitted repeatedly to emergency department and treated as Idiopathic Pancreatitis. Initial labs showed elevated pancreatic enzymes. Detailed history showed that increase in thiazides dosage was the cause of her pancreatitis. It was later diagnosed as a case of thiazide induced pancreatitis. It is important to consider medication as a cause of acute pancreatitis in especially in older people presenting with acute pancreatitis without common risk factors.

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“…However, a recent report of 170 cases of pancreatitis cared for at a single academic medical center in the Czech Republic concluded that drugs were the most likely cause in 5.3 % of cases, making drugs the third most frequent cause of AP aft er gallstones and alcohol ( 3 ). Another report, involving a retrospective review of 138 patients diagnosed with AP from a single center in France, attributed the etiology to drugs in 6.5 % of cases.…”

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confidence: 99%

Drug-Induced Acute Pancreatitis: Uncommon or Commonplace?

Grendell

2011

American Journal of Gastroenterology

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Many drugs have been implicated as causing acute pancreatitis (AP), mainly based on the recurrence of pancreatitis following rechallenge with a drug that the patient had been taking at the time of an initial episode of AP. However, estimates of the relative frequency with which drugs cause AP vary widely. This is largely because many patients may be taking a number of drugs, may have co-morbidities such as gallstone disease or hypertriglyceridemia, or may be consuming large amounts of alcohol, making it diffi cult to determine what actually is the primary cause of an episode of AP. Large, rigorously designed epidemdiological studies are needed to better defi ne the frequency with which the drugs in general cause AP and the specifi c risk of pancreatitis associated with any individual drug. Am J Gastroenterol 2011; 106:2189 -2191 doi: 10.1038/ajg.2011 Drugs have generally been considered to be a relatively uncommon cause of acute pancreatitis (AP), with an estimated incidence of 0.1 -2 % ( 1,2 ). However, a recent report of 170 cases of pancreatitis cared for at a single academic medical center in the Czech Republic concluded that drugs were the most likely cause in 5.3 % of cases, making drugs the third most frequent cause of AP aft er gallstones and alcohol ( 3 ). Another report, involving a retrospective review of 138 patients diagnosed with AP from a single center in France, attributed the etiology to drugs in 6.5 % of cases. However, the authors of this report qualifi ed this estimate by writing " Th is higher rate … must be examined with precaution due to the diffi culty in attributing causality " . ( 4 ).Indeed, it has not been easy to determine whether a specifi c drug is a cause of AP. More than 500 medications have been implicated, but most of the evidence comes from random case reports, with little in the way of sound epidemiological studies ( 5 ). When a case report describes a single exposure to a drug, no reliable conclusions can be made because case reports are oft en incomplete. Reports frequently do not even fully document a reliable diagnosis of AP and oft en have inadequate data regarding the drug dose and duration of treatment before the episode of AP and the extent of eff orts to exclude other common causes of AP. In addition, previous case reports and drug warnings from regulatory agencies may stimulate additional reporting because of heightened awareness of even the possibility a drug may cause AP. Also drugs that are widely used are more likely to be on the medication list of a patient with AP, regardless of the true cause; and new drugs are monitored much more closely for possible adverse eff ects than are medications which have been used for decades. As well stated in a recent review of drug-induced AP, " Th e incidence rates and relative risk of single drugs cannot be determined with the help of case reports alone " ( 2 ).However, one specifi c type of case report has been regarded as decisive in determining whether a drug is a likely cause of AP; i.e., a description of a well...

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Incidence, Severity, and Etiology of Drug-Induced Acute Pancreatitis

Cited by 101 publications

References 20 publications

Case of drug-induced acute pancreatitis produced by horsetail infusions

Case of drug-induced acute pancreatitis produced by horsetail infusions

Primary Isolated Case of Drug Induced Pancreatitis Misdiagnosed as Idiopathic Pancreatitis

Drug-Induced Acute Pancreatitis: Uncommon or Commonplace?

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