Vildagliptin-induced acute pancreatitis without enzyme elevation

Abstract

We describe 2 patients with diabetes mellitus, presenting with upper abdominal pain. Although imaging findings were consistent with acute pancreatitis (AP), serum amylase and lipase levels were within normal limits. In both the cases, the only identifiable diagnostic culprit was vildagliptin. This is the first reported case of vildagliptin causing AP clinically and radiographically without elevated serum pancreatic enzymes. In conclusion, even when serum amylase and lipase levels are normal, AP should be kept in mind when making a differential diagnosis of patients with diabetes mellitus who present with abdominal pain and take dipeptidyl peptidase-4 (DPP-4) inhibitors.

Normal lipase acute pancreatitis: A case report and brief review of literature

“…On review of literature, twenty-three published cases of AP with normal lipase levels were found available and can be accessed through PubMed search online. [4][5][6][7][8][9][10][11][12][13] All retrievable information related to demographic profile, aetiologies, outcomes, etc. are presented in Table 1.…”

“…Nevertheless, a few cases of AP with normal lipase levels have also been reported. [4][5][6][7][8][9][10][11][12][13] We report a similar case of AP, where serum lipase levels surprisingly remained normal throughout the course of the disease. Moreover, a brief review of all such case reports published till 2021 is presented here in a tabulated form (Table 1 and 2, and Figure 1,2,3).…”