Case Of Recurrent Acute Pancreatitis Research Articles

A case of recurrent acute pancreatitis following ocrelizumab use

Acute pancreatitis is an acute inflammatory process of the pancreas. Drugs are a relatively rare cause of acute pancreatitis with an incidence of 0.1-2%. Ocrelizumab is a monoclonal antibody that causes peripheral B lymphocyte suppression by targeting CD20 receptors on B lymphocytes. In this case report, we aimed to present a case of acute pancreatitis after ocrelizumab use. It is thought that suppression of B lymphocytes by ocrelizumab may induce proinflammatory cytokine release and may also cause pancreatitis by disrupting T lymphocyte regulation. Therefore, ocrelizumab should be considered in the etiology of pancreatitis in patients receiving ocrelizumab treatment.

A Novel Adult Case of Recurrent Acute Pancreatitis Caused by Hypercalcemia With Concurrent Manifestation of Posterior Reversible Encephalopathy Syndrome Revealing Undiagnosed Primary Hyperparathyroidism due to an Underlying Parathyroid Adenoma.

Hypercalcemia-induced posterior reversible encephalopathy syndrome (PRES) is a rare entity primarily associated with iatrogenic vitamin D/calcium overdose, malignancy, or, infrequently, primary hyperparathyroidism. We present a novel case of an adult male from rural India who experienced recurrent acute pancreatitis caused by hypercalcemia with concurrent manifestation of PRES. Diagnostic evaluation revealed markedly elevated serum calcium levels and parathyroid hormone concentrations, consistent with primary hyperparathyroidism. Imaging studies identified a parathyroid adenoma near the right thyroid lobe, subsequently surgically excised. This case underscores the importance of considering primary hyperparathyroidism as an underlying cause of PRES, especially in the absence of acute arterial hypertension or autonomic dysfunction. Early recognition and intervention are essential in mitigating the morbidity and mortality of PRES.

S1980 An Abnormal Case of Recurrent Acute Pancreatitis Revealing Adenocarcinoma in a 31-Year-Old Male

S1980 An Abnormal Case of Recurrent Acute Pancreatitis Revealing Adenocarcinoma in a 31-Year-Old Male

S1936 A Not so Common Case of Recurrent Acute Pancreatitis and Its Implications

S1936 A Not so Common Case of Recurrent Acute Pancreatitis and Its Implications

S1446 An Unusual Case of Recurrent Acute Pancreatitis: Metastatic Breast Cancer to the Pancreas Diagnosed via Endoscopic Ultrasound (EUS)

S1446 An Unusual Case of Recurrent Acute Pancreatitis: Metastatic Breast Cancer to the Pancreas Diagnosed via Endoscopic Ultrasound (EUS)

Recurrent Acute Pancreatitis With Energy Drinks Consumption: Rare but Definite Association

Acute pancreatitis is the most common gastrointestinal cause of hospitalization in the United States. Gallstones and alcohol use account for approximately 80 percent of the cases and in remainder the etiology of acute pancreatitis remains unknown. Rare cases of energy drinks as a possible cause of acute pancreatitis have been reported. We report a case of recurrent acute pancreatitis from energy drinks A 19-year-old Caucasian male with Serine Protease Inhibitor Kazal-type 1 (SPINK1) gene mutation had recurrent bouts of acute mild interstitial pancreatitis, 10 admissions in the year of 2017. His presentations include acute onset of deep epigastric pain, lipase level of > 10,000 (u/l). Repeated imaging (Including magnetic resonance imaging with cholangiopancreatography) showed acute mild interstitial pancreatitis without any biliary or additional pancreatic pathology or changes suggestive of chronic pancreatitis. The triglycerides levels ranged from 50 to 77 mg/dL. All episodes responded to conservative management with aggressive fluid resuscitation and pain control without any complications. He was not on any medications or herbal supplement. IgG4 level was 32 mg/dL. He drank Full Throttle (contains taurine, ginseng extract, caffeine, carnitine fumarate, guarana extract) and Red Bull (contains taurine and caffeine) on regular basis. The patient was counselled to abstain from energy drinks. He has not had any recurrence since on 7 months follow-up. Based on strength of association, drugs are considered definite, probable or proposed cause of pancreatitis. Drug is considered as definite cause if patient develops pancreatitis while on the drug, improves on stopping and reoccurs when drug is reintroduced. This case met all the definition's criteria. Additionally, Ayoub et al. reported significant injuries to islet cells and pancreatic acini with energy drinks administration to albino rats. This confirms the biological plausibility of energy drinks causing acute pancreatitis. The mild nature of each of the pancreatitis episode is consistent with drug-induced pancreatitis. Presence of SPINK1 mutation increased this patient's susceptibility to develop acute pancreatitis but it doesn't cause pancreatitis by itself. Energy drinks have definite association with acute pancreatitis and should be discontinued in patients who are at high risk of developing acute pancreatitis such as patient with SPINK1 mutation.1442.tif Figure 1: No Caption available.

A Case Report on Recurrent Acute Pancreatitis with Primary Hyperparathyroidism

Pancreatitis is a common non-bacterial inflammatory disease caused by activation, interstitial liberation and auto digestion of pancreas by its own enzymes. Common causes of acute pancreatitis are gall stones, alcohol, drugs, trauma, viral infections and hypertriglyceridemia. Much is known about the causes of pancreatitis but huge experimental data available about understanding of its pathogenesis is still incomplete. Hypercalcemia as a cause of pancreatitis is rarely reported. Hypercalcemia is usually the result of Primary hyperparathyroidism (PHPT) and the most common cause of PHPT is parathyroid adenoma. It is thought that the increased calcium concentration in pancreatic juice resulting from hypercalcemia may prematurely activate proteases. Mutations in different genes have been proposed as well to justify why only some patients with primary hyperparathyroidism and hypercalcemia develop acute pancreatitis. Here we present a case of recurrent acute pancreatitis resulting from hypercalcemia due to parathyroid adenoma in a 38-year-old man. Hyperparathyroidism was suspected when despite severe pancreatitis calcium level remained high and parathormone level was grossly raisedFaridpur Med. Coll. J. Jan 2016;11(1): 36-38

Recurrent acute pancreatitis in a Saudi child with isovaleric acidemia

Isovaleric acidemia (IVA), also known as the sweaty foot syndrome, is an autosomal recessive organic acid disorder due to a defect in the mitochondrial Flavin Adenine Dinucleotide (FAD)-dependent enzyme isovaleryl CoA dehydrogenase. Acute pancreatitis as a complication has been reported. We are presenting a rare case of recurrent acute pancreatitis complicating a 9-year-old girl with IVA. She presented with repeated attacks of vomiting, severe abdominal pain, and fever since the age of 18 months. These were diagnosed as attacks of pancreatitis with high serum amylase presenting clinically as diabetic ketoacidosis. Later, she developed chronic pancreatitis which is proved by lapratomy. In the last attack, she was comatosed with fulminant sepsis and sooner the patient died. Blood sample taken during this last attack confirmed the diagnosis of IVA. An inborn error of organic acid metabolism should be considered in children with pancreatitis of unknown origin.

A B-wildering Case of Recurrent Acute Pancreatitis

A B-wildering Case of Recurrent Acute Pancreatitis

A case of recurrent acute pancreatitis due to intra-articular corticosteroid injection.

Corticosteroid is a well-established cause of drug-induced pancreatitis. However, acute pancreatitis from intra-articular injection of corticosteroid has never been described.A 69-year-old male presented with acute abdominal pain and was diagnosed with acute pancreatitis. The patient had one episode of acute pancreatitis two year earlier. Both episodes occurred after intra-articular cortisone injection. Investigations for other causes of pancreatitis were negative.We report the first case of acute pancreatitis from intra-articular corticosteroid injection. Physicians should be aware of this adverse reaction of corticosteroid that can even occur with local administration.

A Case of Acute Recurrent Pancreatitis Caused by Proximal Migration of a Prophylactic Pancreatic Stent

ERCP 시행과 연관된 췌장염 발생을 ì˜ˆë°©í•˜ê³ ìž, ê³ ìœ„í—˜êµ°ì—ì„œ 췌관 ìŠ¤í íŠ¸ ì‚½ìž ì´ 널리 ì´ìš©ë˜ê³ ìžˆë‹¤. 그러나 췌관 ìŠ¤í íŠ¸ ì‚½ìž í›„ 췌관의 손상, ìŠ¤í íŠ¸ 폐색, ìŠ¤í íŠ¸ 이탈 등의 합병증이 ë°œìƒí• ìˆ˜ 있으며, 특히 췌관 ìŠ¤í íŠ¸ì˜ 근위부 이탈은 췌장염을 일으킬 수 있다. ì €ìžë“¤ì€ 예방용 췌관 ìŠ¤í íŠ¸ì˜ 근위부 이탈로 인한 급성 재발성 췌장염 환자에서 내시경을 이용하여 ìŠ¤í íŠ¸ë¥¼ íšŒìˆ˜í•˜ê³ ë™ë°˜ëœ 췌관 협착과 췌액 누출을 ì„±ê³µì ìœ¼ë¡œ 치료한 증례를 경험하였기에 이를 ë³´ê³ í•œë‹¤. 중심 단어: 췌장염; ìŠ¤í íŠ¸; 이물질 이탈

Gadolinium induced recurrent acute pancreatitis

Acute pancreatitis is a sudden swelling and inflammation of the pancreas. The two most common causes are alcohol use and biliary stones. Drug-induced acute pancreatitis are rare (1.4–2%). In this present study, we present a case of recurrent acute pancreatitis induced by a specific magnetic-resonance-imaging (MRI) contrast agent called gadobenate dimeglumine.

Recurrent Acute Pancreatitis in situs Ambiguous: First Reported Case

Purpose: Heterotaxy is a rare congenital anomaly that describes abnormal symmetry of the thoracic and abdominal organs and vasculature. Heterotaxy includes anomalies such as situs inversus and situs ambiguous. We report a rare case of recurrent acute pancreatitis in which the clinical picture is complicated by underlying situs ambiguous. Case Report: A 67-year-old woman was admitted with acute abdominal pain and vomiting. Clinical presentation, laboratory values and imaging with CAT scan revealed acute pancreatitis as well as incidental situs ambiguous, polysplenia, and intestinal malrotation. Abdominal ultrasound did not demonstrate any evidence of cholecystitis or cholelithiasis. Further diagnostic workup revealed normal serum triglyceride levels, ANA, and IgG4 levels. All medications were reviewed and medication-induced pancreatitis was ruled out. Patient was treated with intravenous fluids and electrolyte supplementation and discharged home. She presented back one month later with the recurrent abdominal pain. At this time, a CAT scan of the abdomen and pelvis revealed worsening pancreatitis with extensive pararenal phlegmon and pancreatic necrosis. MRCP did not reveal any intrahepatic or extrahepatic biliary ductal dilatation, and no pancreatic ductal abnormalities were noted. Patient was managed conservatively with intravenous fluids and electrolyte supplementation and recovered uneventfully. Conclusion: Recurrent acute pancreatitis has not been reported in the literature in a patient with situs ambiguous. We present a rare case of an adult patient with situs ambiguous, polysplenia, and pancreatitis without any duodenal or biliary malformations directly contributory to her pancreatitis. Our case describes a common clinical problem presenting in the setting of a rare anatomical anomaly. Any patient with heterotaxy/polysplenia syndrome with pancreatitis should be aggressively investigated for structural and biochemical abnormalities that could potentially contribute to pancreatitis.Figure: No Caption available.

Acute pancreatitis associated with hyperlipidemia clinical analysis

Objective To explore the hyperlipidemia associated clinical analysis of acute pancreatitis.Methods My division in January 2005 to January 2010 were treated in compliance with acute pancreatitis associated with hyperlipidemia inclusion criteria were reviewed and 48 cases and analysis.Results 38 patients were in pain relief within 1 ～ 3 d,temperature is normal,10 cases of acute pancreatitis,8 cases of severe pancreatitis after active treatment to alleviate symptoms in about 1 week,major organ function;two cases of multiple organ failure death rate 4.16%.Complications occurred in 19 cases,complication rate was 39.58%.Lowering therapy in 46 cases by 2 months,decreased blood lipids,triglycerides ＜ 4.0 mmol/L,not one case of recurrent acute pancreatitis did not.Conclusion TG ＞ 11.3 mmoL/L high incidence of severe pancreatitis,mortality is high,the high incidence of complications,patients should be higher on TG caused a high degree of clinical importance,ff necessary,to lipid absorption and blood filtration actively prevent the occurrence of complications and mortality. Key words: Hyperlipidemia; Acute pancreatitis; Clinical analysis

A Case of Recurrent Acute Pancreatitis due to Pancreatic Arteriovenous Malformation

Pancreatic arteriovenous malformation (AVM) is an extremely rare condition with various clinical manifestations. We report herein a case of recurrent acute pancreatitis due to pancreatic AVM in a 49-year-old man. This patient presented with epigastric pain that had developed after consuming alcohol 2 days prior to admission. Serum amylase and lipase levels were elevated and computed tomography revealed focal low-attenuation lesions with peripancreatic infiltrations in the pancreatic tail and multiple collateral vessels around the low-attenuation lesions. He was diagnosed with acute pancreatitis and pancreatic AVM. Although he had stopped drinking after the first attack of acute pancreatitis, his pancreatitis recurred twice within 3 months. He underwent a distal pancreatectomy after the third attack of acute pancreatitis. He was free of symptoms for 2 years after the pancreatectomy.

Recurrent acute pancreatitis as a manifestation of Wegener's granulomatosis

We report a case of recurrent acute pancreatitis in a 57-year-old man with reactivation of Wegener's granulomatosis. An association between acute pancreatitis and Wegener's granulomatosis has not been reported previously. Six episodes of abdominal pain and hyperamylasemia occurred and were complicated by development of a pancreatic pseudocyst. New cavitary lung lesions typical of Wegener's granulomatosis led to treatment with increased glucocorticoid dosage, resulting in rapid resolution of the pancreatitis and pulmonary lesions. Acute pancreatitis may be a clinical manifestation of the histologic pancreatic vasculitis observed in Wegener's granulomatosis. Reactivation of Wegener's granulomatosis should be considered when a patient with the disorder develops otherwise unexplained acute pancreatitis.