Successful Management of a Child With Drug-induced Necrotizing Pancreatitis During Acute Lymphoblastic Leukemia Therapy: A Case Report

Płotka, Anna; Wziątek, Agnieszka; Wachowiak, Jacek; Derwich, Katarzyna

doi:10.1097/mph.0000000000001181

Cited by 4 publications

(5 citation statements)

References 19 publications

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“…The most common complication of the entire cohort was hyperglycemia requiring insulin therapy in 6 patients (46%): in 3 cases, insulin was discontinued after the resolution of pancreatitis [18,23], in 1 child, it was stopped after one year [20], and in 2 patients, diabetes persisted despite recovering from acute pancreatitis [6]. Other reported complications were peripancreatic fluid collection and/or pseudocysts in 5/13 patients (38%) [19,20,22,23], one of them treated with percutaneous drainage [20], and another one who underwent surgical intervention for fat necrosis of the transverse colon [22]: both these two surgically treated patients presented necrotizing AAP. Confirming the severity of this subtype of pancreatitis, 5/6 patients (83%) suffering from necrotizing AAP developed acute complications.…”

Section: Discussionmentioning

confidence: 99%

“…There are no large studies about the use of octreotide in pediatric patients with AAP. In literature, we found only a few pertinent articles [6,[17][18][19][20][21][22][23]. Including our patient, we identified 13 children (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…Including our patient, we identified 13 children (Table 1). Six patients were affected by necrotizing AAP [19][20][21][22][23]; three cases had edematous pancreatitis [17,18], while in 4/13 the type of pancreatitis was not reported [6]. The median age was 8 years; only three [26].…”

Section: Discussionmentioning

confidence: 99%

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2024

Int J Pediatr Res

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Pancreatitis is a common adverse reaction to asparaginase and a reason for drug discontinuation in patients with acute lymphoblastic leukemia. Diagnostic criteria include elevated pancreatic enzymes, abdominal symptoms and/ or imaging findings suggestive of pancreatitis. There is no specific treatment, but in a few reports, octreotide seems to be an effective drug in reducing acute complications and mortality. Here we describe the case of a child who developed asparaginase-induced necrotizing pancreatitis, successfully treated with octreotide. A review of the literature indicated that evidence of necrotizing pancreatitis markedly increases the risk of acute and chronic complications, and patients who received octreotide usually improved without surgical intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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2024

Int J Pediatr Res

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“…Acute pancreatitis in childhood ALL is usually caused by medications such as L-asparginase, peg-asparginase, and steroids. About 80 -90% of cases are mild and in a small percentage may be hemorrhagic or necrotizing (4). The incidence of drug-induced pancreatitis in childhood ALL is 6.7 -18% (5).…”

Section: Discussionmentioning

confidence: 99%

Acute Pancreatitis as a Rare and Unusual Manifestation of COVID-19 in a Child with Acute Lymphoblastic Leukemia

Miri‐Aliabad

Dahmardeh

2023

Int J Cancer Manag

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Introduction: The coronavirus disease 2019 (COVID-19) mainly causes pulmonary disease. However, extrapulmonary manifestations, which affect the gastrointestinal tract and hepatobiliary system, have been reported. Case Presentation: Here we reported a 4-year-old boy with acute lymphoblastic leukemia and abdominal pain who had acute necrotic pancreatitis secondary to COVID-19. Conclusions: According to the COVID-19 epidemic, if drug-induced pancreatitis is ruled out, viral causes, especially COVID-19, should be considered.

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“…Chemotherapy drug-related acute pancreatitis (CDRAP) is a rare adverse event that is often challenging for clinicians [12]. Limited data, mainly a few case reports [13,14], simply describe imaging manifestations of drug-related pancreatitis as diagnostic evidence. Thus, the objective of this article is to discuss the CT ndings of CDRAP and to provide evidence about pancreatitis for clinicians.…”

Section: Introductionmentioning

confidence: 99%

CT findings of chemotherapy drug-related acute pancreatitis

Zuo

Fan

Shi

et al. 2022

Preprint

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Purpose To describe plain and contrast-enhanced computed tomography (CT) findings of chemotherapy drug-related acute pancreatitis in patients with malignances. Methods Twenty-two patients with first clinical and/or biochemical evidence of pancreatitis who underwent plain and/or contrast-enhanced CT while being treated with chemotherapy were retrospectively included in the study. Chemotherapy drug-related acute pancreatitis (CDRAP) diagnosis was obtained based on clinical, imaging, and biochemical findings. CT features of CDRAPwere recorded as follows: normal pancreas morphology, pancreatic enlargement (diffuse or focal), enhancing but heterogeneous parenchyma (diffuse or focal), peripancreatic stranding, acute peripancreatic fluid collection, pseudocyst, acute necrotic collections (pancreatic necrosis and peripancreatic necrosis) and main pancreatic duct dilatation. In addition, the baseline demographics, clinical, biochemical, other complications, chemotherapy drugs, and outcomes of the pancreas were also included. Results CT showed that five (23%) patients demonstrated normal pancreas, whereas 17 (77%) patients presented with acute pancreatitis changes in clinically diagnosed CDRAP patients. The CT findingsof 22 CDRAPs were as follows: diffuse (n=7) or focal (n=8) pancreatic enlargement, diffuse (n=6) or focal (n=1) heterogeneousenhancement, peripancreatic stranding (n=5), acute peripancreatic fluid collection (n=7), and pseudocyst (n=1). No patients developed acute necrotic collections or dilatation of the main pancreatic duct. The severity classification of acute pancreatitis in most people (81%) wasmild pancreatitis. Other complications were drug-induced hepatitis (n=3), polycranial neuropathy (n=1), and death (n=1).Regarding theoutcomes of the pancreas, two patients developed acute pancreatitis changes on CT in five initial normal pancreas morphologies. Conclusion Chemotherapy-related acute pancreatitis mainly presented as interstitial edematous pancreatitis and/or a normal pancreas on CT. Most living patients experienced mild acute pancreatitis. Patients with other risk factors for acute pancreatitis might easily develop CDRAP, which needs more attention.

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Successful Management of a Child With Drug-induced Necrotizing Pancreatitis During Acute Lymphoblastic Leukemia Therapy: A Case Report

Cited by 4 publications

References 19 publications

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Untitled

Acute Pancreatitis as a Rare and Unusual Manifestation of COVID-19 in a Child with Acute Lymphoblastic Leukemia

CT findings of chemotherapy drug-related acute pancreatitis

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