Steroid-Induced Pancreatitis: Establishing an Accurate Association Poses a Challenge

Abstract

The association between steroids and pancreatitis has been reported in the literature. However, due to its rarity, it can be challenging to make an early diagnosis. Hence, when diagnosing patients presenting with signs and symptoms of pancreatitis, there should be a high suspicion for medication-induced variants, after ruling out other common causes. In our report, we present the case of an individual with recurrent pancreatitis caused by the use of prednisone for musculoskeletal pain, the probable cause being steroids due to a high Naranjo score. The patient experienced clinical improvement with the resolution of pancreatitis after the steroids were discontinued.

Acute pancreatitis associated with Cushing syndrome – A case report and literature review

“…The main etiologic factors are gallstones and alcohol [ 13 ]. Other risk factors are genetic predisposition, drugs, smoking, hypertriglyceridemia, type 2 diabetes and endoscopic retrograde cholangiopancreatography [ 14 ]. Drugs are responsible for 0.1%–2% of incidents of acute pancreatitis [ 15 ].…”

A Case of Acute Pancreatitis in a Patient Receiving High-Dose Steroids for Optic Neuritis

“…Owing to the significant number of deaths reported in the patients with steroid-induced acute pancreatitis, this class of drugs is thought to cause a severe disease course [7]. [3,4].…”

“…and infection, pancreatic pseudocyst, chronic pancreatitis, and multiorgan failure [4]. A thorough review of the patients' medications is important in all cases of acute pancreatitis.…”

“…Its severity varies from patient to patient, but it is often low to moderate in severity and is usually not accompanied by complications [ 2 ]. Only a few cases of steroid-induced pancreatitis have been described previously in the literature [ 3 , 4 ]. A comprehensive study showed an increased risk of acute pancreatitis among users of oral glucocorticoids instead of the non-users (OR: 1.53; 95% CI, 1.27-1.84) [ 5 ].…”

“…Ataallah et al reported the case of a 20-year-old man who developed steroid-induced pancreatitis after being treated with intravenous Dexamethasone during hospitalization and oral prednisone after discharge for idiopathic immune purpura[3]. Similarly, Minupuri et al presented a 61-year-old female who developed acute pancreatitis on two different occasions, both occurring after steroid exposure (prednisone 10 mg/day)[4]. In concordance with our findings, Ataallah et al and Minupuri et al diagnosed steroid-induced pancreatitis based on the recent history of steroid use after ruling out other potential causes of acute pancreatitis.…”