Abstract
AbstractParkinson’s disease represents one of the most common chronic neurodegenerative diseases in the elderly caused by a reduction of dopamine levels in the brain. The number of people with Parkinson’s disease is expected to grow mostly due to an increase in the aging population. Parkinsonian patients often require complicated dosing or titration schedules and often have multiple comorbidities that necessitate administration of therapies from multiple drug classes. Here we report two cases of parkinsonian patients who suffered acute pancreatitis. The first case presentation covers drug-induced acute pancreatitis in a patient receiving multiple medications, while the second case reveals the complexity of parkinsonian patient treatment in the clinical context of severe recurrent cholecystic acute pancreatitis. Conclusion: We can conclude that the management of Parkinson’s disease and coexistent health problems is extremely sensitive and requires a multidisciplinary team approach. It is therefore importan...
Highlights
Acute pancreatitis (AP) represents a diffuse systemic immuno-inflammatory response to a localized process of autodigestion within the pancreatic gland, caused by a premature activation of proteolytic digestive enzymes
The estimated incidence of drug-induced acute pancreatitis varies from 1.4% in a retrospective study conducted in Germany and published in 1995 (Lankisch, Droge, & Gottesleben, 1995), to 3.4% in a more recent study performed in Australia in 2011 (Badalov et al, 2007; Barreto, Tiong, & Williams, 2011)
A definite causality for acute pancreatitis has been established for 31 drugs, with the highest hazard ratios for mesalazine, azathioprine, and simvastatin (Nitsche, Jamieson, Lerch, & Mayerle, 2010)
Summary
Acute pancreatitis (AP) represents a diffuse systemic immuno-inflammatory response to a localized process of autodigestion within the pancreatic gland, caused by a premature activation of proteolytic digestive enzymes. It can range in intensity from a mild self-limiting disease to a severe disorder with prolonged hospitalization and high morbidity of complications (Harper & Cheslyn-Curtis, 2011; Sheu, Furlan, Almusa, Papachristou, Bae, 2012). In terms of population aging and progress of medicine the more links in the organism are damaged, the more pharmacological efforts are needed for a productive effect on the damaged system In this context, drug-related acute pancreatitis is definitely gaining relevance. The second parkinsonian patient in an attack of severe recurrent cholecystic acute pancreatitis developed neuroleptic malignant-like syndrome caused by unintentional withdrawal of antiparkinsonian medication due to poor intestinal absorption
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