Lansoprazole induced pancreatitis

Abstract

Drug-induced pancreatitis is a rare and sometimes fatal cause of pancreatitis which is often difficult to diagnose. Acid suppressing medications include histamine-2 receptor antagonists and proton pump inhibitors have been linked to acute pancreatitis in several case-reports and recent systematic reviews. However, only one case of lansoprazole induced pancreatitis has been described in literature until date. A 67-year-old female presented with complaints of abdominal pain, nausea, vomiting and worsening generalized weakness for the past 1 week. She had recently been started on lansoprazole therapy for gastroesophageal reflux with no other change in medications. She denied any trauma, recent viral infection, alcohol intake, over-the-counter or herbal medication use. On presentation, she had abdominal distension with tenderness and epigastric guarding. Laboratory investigations were significant for leukocytosis and elevated amylase and lipase with normal triglyceride levels. Computed tomography of the abdomen and pelvis with contrast revealed features of acute interstitial pancreatitis with retroperitoneal lymphadenopathy and no other abnormality. She was diagnosed to have acute pancreatitis secondary to lansoprazole therapy and was managed conservatively. Her symptoms resolved after 3 days of discontinuation of the drug. There have been several cases reporting a potential link between acute pancreatitis and acid suppressing medications. However, drug-induced pancreatitis still remains a diagnosis of exclusion as it is difficult to establish causality. Almost all the acid suppressing medications have been linked to pancreatitis, but a case associated with lansoprazole has only been described once. Further studies are needed to establish causation.