P.04.7: Ethinylestradiol/Levonorgestrel Oral Contraceptive and Acute Pancreatitis: A Case Series

Acute pancreatitis (AP) appears to be rare disease in childhood. In children, it has a different aetiology and course, and requires different management than in adult patients. The diagnosis of AP is based on at least two of the three criteria, which include typical clinical symptoms, abnormalities in laboratory tests and/or imaging studies of the pancreas. There are many known causes leading to AP in children including infections, blunt abdominal trauma, genetic factors, gallstone disease, metabolic disorders, anatomical defects of the pancreas, systemic diseases, as well as drugs, including antiepileptic drugs, and especially preparations of valproic acid. In our study, we present four cases of young patients diagnosed with acute pancreatitis as a complication of valproic acid therapy and we present a review of the literature. We believe that the activity of pancreatic enzymes should be monitored in children treated with valproate preparations in the case of clinical symptoms suggesting AP.

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The Risk of Acute Pancreatitis and Selective Serotonin Reuptake Inhibitors Use: A Meta-Analysis of Case–Control Studies

Dose-Response ◽

10.1177/1559325820902352 ◽

2020 ◽

Vol 18 (1) ◽

pp. 155932582090235

Author(s):

Shih-Wei Lai ◽

Cheng-Chan Yu ◽

Cheng-Li Lin ◽

Kuan-Fu Liao

Keyword(s):

Acute Pancreatitis ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Meta Analysis ◽

Statistical Significance ◽

Case Series ◽

Serotonin Reuptake Inhibitors ◽

Selective Serotonin ◽

Statistical Association ◽

Case Control Studies

Background/Objective: Some case series and case report have shown the association between the risk of acute pancreatitis and use of selective serotonin reuptake inhibitors. The results of systematic studies were not consistent. Methods: A meta-analysis was performed to investigate the risk of acute pancreatitis associated with use of selective serotonin reuptake inhibitors. Results: There was no statistical association between the risk of acute pancreatitis and selective serotonin reuptake inhibitors use (odds ratio: 1.19, 95% confidence interval: 0.93-1.51). Conclusions: Despite reaching no statistical significance, the possibility of the association between the risk of acute pancreatitis and selective serotonin reuptake inhibitors use cannot be totally excluded.

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Acute Pancreatitis: An Atypical Presentation

Case Reports in Gastroenterology ◽

10.1159/000475920 ◽

2017 ◽

Vol 11 (2) ◽

pp. 359-363 ◽

Cited By ~ 1

Author(s):

Omar Nadhem ◽

Omar Salh

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Case Reports ◽

Case Series ◽

Normal Serum ◽

Intravenous Fluids ◽

Serum Enzyme ◽

Serum Lipase ◽

Upper Abdominal ◽

Symptoms And Signs

Acute pancreatitis is an important cause of acute upper abdominal pain. Because its clinical features are similar to a number of other acute illnesses, it is difficult to make a diagnosis only on the basis of symptoms and signs. The diagnosis of acute pancreatitis is based on 2 of the following 3 criteria: (1) abdominal pain consistent with pancreatitis, (2) serum lipase and/or amylase ≥3 times the upper limit of normal, and (3) characteristic findings from abdominal imaging. The sensitivity and specificity of lipase in diagnosing acute pancreatitis are undisputed. However, normal lipase level should not exclude a pancreatitis diagnosis. In patients with atypical pancreatitis presentation, imaging is needed. We experienced two cases of acute pancreatitis associated with normal serum enzyme levels. Both patients were diagnosed based on clinical and radiological evidence. They were successfully treated with intravenous fluids and analgesics with clinical and laboratory improvement. The importance of this case series is the unlikely presentation of acute pancreatitis. We believe that more research is needed to determine the exact proportion of acute pancreatitis patients who first present with normal serum lipase, since similar cases have been seen in case reports.

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Antiretroviral drugs and acute pancreatitis in HIV/AIDS patients: is there any association? A literature review

Einstein (São Paulo) ◽

10.1590/s1679-45082014rw2561 ◽

2014 ◽

Vol 12 (1) ◽

pp. 112-119 ◽

Cited By ~ 23

Author(s):

Natalia Mejias Oliveira ◽

Felipe Augusto Yamauti Ferreira ◽

Raquel Yumi Yonamine ◽

Ethel Zimberg Chehter

Keyword(s):

Acute Pancreatitis ◽

Antiretroviral Therapy ◽

Opportunistic Infections ◽

Case Reports ◽

Case Series ◽

Antiretroviral Drugs ◽

Pancreatic Involvement ◽

Frequent Event ◽

Hiv Seropositive ◽

Hiv Aids

In HIV-seropositive individuals, the incidence of acute pancreatitis may achieve 40% per year, higher than the 2% found in the general population. Since 1996, when combined antiretroviral therapy, known as HAART (highly active antiretroviral therapy), was introduced, a broad spectrum of harmful factors to the pancreas, such as opportunistic infections and drugs used for chemoprophylaxis, dropped considerably. Nucleotide analogues and metabolic abnormalities, hepatic steatosis and lactic acidosis have emerged as new conditions that can affect the pancreas. To evaluate the role of antiretroviral drugs to treat HIV/AIDS in a scenario of high incidence of acute pancreatitis in this population, a systematic review was performed, including original articles, case reports and case series studies, whose targets were HIV-seropositive patients that developed acute pancreatitis after exposure to any antiretroviral drugs. This association was confirmed after exclusion of other possible etiologies and/or a recurrent episode of acute pancreatitis after re-exposure to the suspected drug. Zidovudine, efavirenz, and protease inhibitors are thought to lead to acute pancreatitis secondary to hyperlipidemia. Nucleotide reverse transcriptase inhibitors, despite being powerful inhibitors of viral replication, induce a wide spectrum of side effects, including myelotoxicity and acute pancreatitis. Didanosine, zalcitabine and stavudine have been reported as causes of acute and chronic pancreatitis. They pose a high risk with cumulative doses. Didanosine with hydroxyurea, alcohol or pentamidine are additional risk factors, leading to lethal pancreatitis, which is not a frequent event. In addition, other drugs used for prophylaxis of AIDS-related opportunistic diseases, such as sulfamethoxazole-trimethoprim and pentamidine, can produce necrotizing pancreatitis. Despite comorbidities that can lead to pancreatic involvement in the HIV/AIDS population, antiretroviral drug-induced pancreatitis should always be considered in the diagnosis of patients with abdominal pain and elevated pancreatic enzymes.

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Functional outcomes in women with neurological complications secondary to oral contraceptive pills: A case series

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1063 ◽

2021 ◽

Vol 2 (2) ◽

Author(s):

Nidhi Rawat ◽

◽

Anit Catherine Charls ◽

Keyword(s):

Oral Contraceptive ◽

Functional Outcomes ◽

Case Series ◽

Neurological Complications ◽

Rehabilitation Program ◽

Physical Medicine ◽

Oral Contraceptive Pills ◽

Cerebrovascular Complications ◽

Contraceptive Pills ◽

History Of

Cerebrovascular complications of Oral Contraceptive Pills (OCPs) are recorded in literature. We present a case series of 4 women who were admitted in the Department of Physical Medicine and Rehabilitation after having cerebrovascular complications. The only risk factor which was identified was the history of OCPs intake. The cerebrovascular accident ranged from arterial stroke to cerebral venous thrombosis (CVT-3, arterial stroke-1). All of them underwent rehabilitation for 3 weeks. Two out of three CVT patients had good functional recovery. A targeted rehabilitation program during the early phase of the condition results in better functional outcome in patients.

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Non-occlusive Mesenteric Ischemia as a Fatal Complication in Acute Pancreatitis: A Case Series

Digestive Diseases and Sciences ◽

10.1007/s10620-019-05835-9 ◽

2019 ◽

Vol 65 (4) ◽

pp. 1212-1222 ◽

Cited By ~ 2

Author(s):

Cynthia Reichling ◽

Leda Nobile ◽

Martina Pezzullo ◽

Julie Navez ◽

Najla Bachir ◽

...

Keyword(s):

Acute Pancreatitis ◽

Mesenteric Ischemia ◽

Case Series ◽

Fatal Complication ◽

Occlusive Mesenteric Ischemia

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Tu1459 – A Pain in the Gut: A Rare Case Series of Siblings with Lipoprotein Lipase Deficiency and Associated Acute Pancreatitis

Gastroenterology ◽

10.1016/s0016-5085(19)39572-1 ◽

2019 ◽

Vol 156 (6) ◽

pp. S-1046-S-1047

Author(s):

Rekha Reddy ◽

Savanna Thor

Keyword(s):

Acute Pancreatitis ◽

Lipoprotein Lipase ◽

Rare Case ◽

Case Series ◽

Lipoprotein Lipase Deficiency

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Therapeutic approaches in hypertriglyceridemia‐induced acute pancreatitis: A literature review of available therapies and case series

Journal of Clinical Apheresis ◽

10.1002/jca.21763 ◽

2019 ◽

Vol 35 (2) ◽

pp. 131-137 ◽

Cited By ~ 3

Author(s):

Abdulaziz Joury ◽

Mona Alshehri ◽

Arjun Mahendra ◽

Mahmoud Anteet ◽

Mohammad A. Yousef ◽

...

Keyword(s):

Acute Pancreatitis ◽

Literature Review ◽

Case Series ◽

Therapeutic Approaches

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Acute pancreatitis in children from Valproic acid: case series and review

Pediatric Neurology ◽

10.1016/s0887-8994(02)00517-9 ◽

2003 ◽

Vol 28 (2) ◽

pp. 145-148 ◽

Cited By ~ 42

Author(s):

Nancy L Grauso-Eby ◽

Olga Goldfarb ◽

Lori B Feldman-Winter ◽

Gary N McAbee

Keyword(s):

Valproic Acid ◽

Acute Pancreatitis ◽

Case Series

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Physician-Controlled Wire-Guided Cannulation of the Minor Papilla

Diagnostic and Therapeutic Endoscopy ◽

10.1155/2010/629308 ◽

2010 ◽

Vol 2010 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

John T. Maple ◽

Lilah Mansour ◽

Tarek Ammar ◽

Michael Ansstas ◽

Gregory A. Coté ◽

...

Keyword(s):

Acute Pancreatitis ◽

Chronic Pancreatitis ◽

Stent Placement ◽

Case Series ◽

Pancreatic Stent ◽

Tertiary Referral ◽

Recurrent Acute Pancreatitis ◽

Minor Papilla ◽

Safe Technique

Background. Minor papilla (MiP) cannulation is frequently performed using specialized small-caliber accessories. Outcomes data for MiP cannulation with standard-sized accessories are lacking. Methods. This is a case series describing MiP cannulation outcomes in consecutive patients treated by two endoscopists between July 2005 and November 2008 at two tertiary referral centers. MiP cannulation was attempted using a 4.4 Fr tip sphincterotome loaded with a , 260 cm hydrophilic-tip guidewire, using a wire-guided technique under physician control. Results. 25 patients were identified (14 women, mean age 45). Procedure indications included recurrent acute pancreatitis in 16 patients (64%) and chronic pancreatitis in 2 (8%), among other indications. MiP cannulation was successful in 24 patients (96%). Sphincterotomy followed by pancreatic stent placement was performed in 21 patients (84%). Mild post-ERCP pancreatitis occurred in 3 patients (12%). Conclusion. Physician-controlled wire-guided MiP cannulation using a 4.4 Fr sphincterotome and guidewire is an effective and safe technique.

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