Primary Isolated Case of Drug Induced Pancreatitis Misdiagnosed as Idiopathic Pancreatitis

Ali Raza Ghani, Kanwal Saba, Mulazzim Hussain, Amjad G. Sheikh

Department of Pathology, King Edward Medical University, Lahore, Pakistan.
Department of Pathology, School of Medicine, American University of Barbados, Wildey, Barbados.
Medicine & Pediatrics Carthage Area Hospital, Carthage, USA.
Thomas Jefferson University Hospital, Philadelphia, USA.

DOI: 10.4236/crcm.2014.37092                

Abstract

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.

Keywords

Acute Pancreatitis, Diagnosis, CT Scan, Gastroscopy, Thiazides, Hypertension, Lipase, ERCP

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	IAP/APA (2013) Evidence-Based Guidelines for the Management of Acute Pancreatitis. Pancreatology: Official Journal of the International Association of Pancreatology (IAP), 13, e1-e15.
[2]	Johnstone, M., Marriott, P., Royle, T.J., Richardson, C.E., Torrance, A., Hepburn, E., et al. (2014) The Impact of Timing of Cholecystectomy Following Gallstone Pancreatitis. The Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland, 12, 134-140.
[3]	Tenner, S., Baillie, J., DeWitt, J. and Vege, S.S. (2013) American College of Gastroenterology Guideline: Management of Acute Pancreatitis. The American Journal of Gastroenterology, 108, 1400-1416.
[4]	Kim, D.B., Cho, Y.K., Song, H.J. and Song, B.C. (2013) A Case of Acute Pancreatitis and Acute Hepatitis Caused by Ingestion of Ceramiumkondoi. The Korean Journal of Gastroenterology, 62, 306-309.
[5]	Sekimoto, M., Takada, T., Kawarada, Y., Hirata, K., Mayumi, T., Yoshida, M., Hirota, M., Kimura, Y., Takeda, K., Isaji, S., et al. (2006) JPN Guidelines for the Management of Acute Pancreatitis: Epidemiology, Etiology, Natural History, and Outcome Predictors in Acute Pancreatitis. Journal of Hepato-Biliary-Pancreatic Surgery, 13, 10-24. http://dx.doi.org/10.1007/s00534-005-1047-3
[6]	Vinklerova, I., Prochazka, M., Prochazka, V. and Urbanek, K. (2010) Incidence, Severity, and Etiology of Drug-Induced Acute Pancreatitis. Digestive Diseases and Sciences, 55, 2977-2981. http://dx.doi.org/10.1007/s10620-010-1277-3
[7]	Lankisch, P.G., Droge, M. and Gottesleben, F. (1995) Drug Induced Acute Pancreatitis: Incidence and Severity. Gut, 37, 565-567. http://dx.doi.org/10.1136/gut.37.4.565
[8]	Garg, R., Chen, W. and Pendergrass, M. (2010) Acute Pancreatitis in Type 2 Diabetes Treated with Exenatide or Sitagliptin: A Retrospective Observational Pharmacy Claims Analysis. Diabetes Care, 33, 2349-2354. http://dx.doi.org/10.2337/dc10-0482
[9]	Neoptolemos, J.P., Raraty, M., Finch, M. and Sutton, R. (1998) Acute Pancreatitis: The Substantial Human and Financial Costs. Gut, 42, 886-891. http://dx.doi.org/10.1136/gut.42.6.886
[10]	Soran, A., Chelluri, L., Lee, K.K. and Tisherman, S.A. (2000) Outcome and Quality of Life of Patients with Acute Pancreatitis Requiring Intensive Care. The Journal of Surgical Research, 91, 89-94. http://dx.doi.org/10.1006/jsre.2000.5925
[11]	Badalov, N., Baradarian, R., Iswara, K., Li, J., Steinberg, W. and Tenner, S. (2007) Drug-Induced Acute Pancreatitis: An Evidence-Based Review. Clinical Gastroenterology and Hepatology: The Official Clinical Practice Journal of the American Gastroenterological Association, 5, 648-661.
[12]	Engel, T., Justo, D., Amitai, M., Volchek, Y. and Mayan, H. (2013) Nilotinib-Associated Acute Pancreatitis. The Annals of Pharmacotherapy, 47, e3. http://dx.doi.org/10.1345/aph.1R334
[13]	Underwood, T.W. and Frye, C.B. (1993) Drug-Induced Pancreatitis. Clinical Pharmacy, 12, 440-448.