RESEARCH - Incidence, severity, and etiology of drug-induced acute pancreatitis

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Dig Dis Sci. 2010 Oct;55(10):2977-81.

Incidence, severity, and etiology of drug-induced acute pancreatitis.

Vinklerová I, Procházka M, Procházka V, Urbánek K.

2nd Department of Internal Medicine, Faculty of Medicine and

University Hospital, Palacký University, Olomouc, Czech Republic.

Abstract

INTRODUCTION: Drug-induced acute pancreatitis is considered to be a

rare diagnosis. The incidence of drug-induced acute pancreatitis is

usually estimated from case reports.

AIM: The aim of this study was to determine the incidence, etiology,

and severity of drug-induced pancreatitis during a 2-year period in a

tertiary hospital.

METHODS: The study was conducted as a retrospective analysis of all

cases of pancreatitis in the University Hospital in Olomouc (1,432

beds) in 2006-2007. All cases of acute pancreatitis were re-evaluated

and divided according to the causative factor. In drug-induced cases,

the WHO Probability Scale for the evaluation of causality relationship

was used.

RESULTS: The inclusion criteria were met by 170 medical files. There

were 91 (53%) cases in men and 79 (47%) in women, and mean age was 57

years old (5-91 years old). The etiology was in 53% biliary, 31%

alcohol-induced, 12% other determined, and in 4% the cause could not

be established. The proportion of drug-induced acute pancreatitis was

5.3% and it was the third most frequent cause of the AP. Azathioprine

was the most frequent causative factor (three cases in two patients);

all the other causative drugs were documented only in single cases:

mesalazine, dexamethasone, ramipril, mycophenolate mofetil,

cytarabine, and valproate.

CONCLUSIONS: The diagnosis of drug-induced acute pancreatitis seems to

be underestimated because of the difficulties in determining the

causative agent and the need for a retrospective re-evaluation of the

suspected causative factors. The disease is more probable in younger

persons, women, and patients suffering from Crohn's disease.

PMID: 20499176

http://www.ncbi.nlm.nih.gov/pubmed/20499176

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