Bictegravir/emtricitabine/tenofovir alafenamide-induced acute pancreatitis: a case report

2020 ◽  
Vol 31 (10) ◽  
pp. 1008-1010 ◽  
Author(s):  
Agostino Riva ◽  
Dario Cattaneo ◽  
Carlo Filice ◽  
Cristina Gervasoni
Keyword(s):  
Acute Pancreatitis ◽  
Epigastric Pain ◽  
Abdominal Ultrasound ◽  
Laboratory Examination ◽  
Pancreatic Parenchyma ◽  
Single Tablet Regimen ◽  
Serum Transaminases ◽  
Recent Diagnosis ◽  
Tenofovir Alafenamide ◽  
Severe Epigastric Pain

We report here the case of a 32-year-old male with recent diagnosis of HIV that, 45 days after starting a single tablet regimen co-formulated with bictegravir, emtricitabine and tenofovir alafenamide (BIC/FTC/TAF), experienced severe epigastric pain radiating to the back, nausea, episodes of non-bloody non-bilious vomiting and anorexia. Laboratory examination showed a rise in lipase with no alterations in serum transaminases. Abdominal ultrasound revealed a non-homogeneous structure of the pancreatic parenchyma. A diagnosis of mild drug-related acute pancreatitis was made and BIC/FTC/TAF was immediately stopped. The association between the episode of acute pancreatitis and BIC/FTC/TAF was scored as probable according to the Naranjo causality scale.

scholarly journals ACUTE PANCREATITIS IN PREGNANCY

2012 ◽  
Vol 19 (05) ◽  
pp. 747-750
Author(s):  
SHAMA CHAUDHRY ◽  
RUBINA HUSSAIN
Keyword(s):  
Acute Pancreatitis ◽  
Caesarean Section ◽  
Maternal Mortality ◽  
Dermoid Cyst ◽  
Conservative Management ◽  
Epigastric Pain ◽  
Fetal Loss ◽  
Pedal Edema ◽  
Severe Epigastric Pain ◽  
In Pregnancy

Acute pancreatitis during pregnancy is rarely encountered and can have a high maternal mortality and fetal loss. We report herea case of a 35-year-old woman para 1+0 previous 1LSCS at 32 weeks of gestation. She had laparotomy at 29 weeks of gestation due to torsionof dermoid cyst in this pregnancy. Now she was presented with, severe epigastric pain, vomiting and pedal edema. Investigation revealedhyperamylasemia and leukocytosis, hypokalemia, hypocalcaemia. The patient was kept on conservative management, antibiotics, analgesics& intravenous fluids.Pancreatitis resolved & she delivered at 38 weeks by caesarean section.

scholarly journals Recurrent Acute Pancreatitis following Colonoscopic Fecal Microbiota Transplantation for Ulcerative Colitis

2021 ◽  
Author(s):  
Avnish Kumar Seth ◽  
Mahesh Kumar Gupta ◽  
Radha Krishan Verma
Keyword(s):  
Acute Pancreatitis ◽  
Fecal Microbiota Transplantation ◽  
Epigastric Pain ◽  
Symptomatic Treatment ◽  
Fecal Microbiota ◽  
Recurrent Acute Pancreatitis ◽  
Serum Lipase ◽  
Fecal Microbiota Transplant ◽  
Enhanced Computed Tomography ◽  
Severe Epigastric Pain

AbstractA 37-year-old man with corticosteroid-dependent ulcerative pancolitis was taken up for colonoscopic fecal microbiota transplant (FMT). Preparation for colonoscopy was done with 118 g polyethylene glycol (PEG) in 2 L water ingested over 2 hours, followed by clear fluids. 200 g of screened donor stool, blended with water was instilled into terminal ileum; cecum; and ascending, transverse, and descending colon. Eighteen hours following ingestion of PEG and 2 hours following FMT, he complained of severe epigastric pain with radiation to back. Serum lipase was 6,756 U/L. He was managed with intravenous (IV) fluids and symptomatic treatment with discontinuation of corticosteroids and 6-MP. Ultrasound did not reveal gall bladder stones or sludge. There was no history of alcohol intake. Contrast-enhanced computed tomography scan at 48 hours showed bulky pancreas with peripancreatic stranding. He recovered over a week with normalization of lipase. Three weeks later he again reported severe epigastric pain 14 hours following ingestion of PEG, this time prior to colonoscopic FMT. Serum lipase was 1,140 U/L; the procedure was deferred and he recovered with symptomatic treatment over 3 days. Maintenance colonoscopic FMT was performed 4 times over the following 2 years with sodium phosphate preparation with no recurrence of pain. MRCP showed no evidence of chronic pancreatitis. He remains in clinical and endoscopic steroid-free, thiopurine-free remission. PEG is a rare cause of acute pancreatitis and merits consideration in appropriate clinical setting.

Spontaneous common bile duct perforation in an adult female patient presenting with severe epigastric pain mimicking acute pancreatitis

2016 ◽  
Vol 14 (2) ◽  
pp. 46
Author(s):  
MuhammadAbd El-Gawad Shawky ◽  
AmroMetwally Hassan ◽  
MohammedFakhry Mohammed ◽  
HamdyMahfouz Moustafa ◽  
Abd El-MonemAbd El-Fatah Mohammed ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Female Patient ◽  
Adult Female ◽  
Epigastric Pain ◽  
Severe Epigastric Pain ◽  
Adult Female Patient ◽  
Bile Duct Perforation

scholarly journals Pancreatitis Induced by Cocaine

2017 ◽  
Vol 11 (1) ◽  
pp. 212-218 ◽  
Author(s):  
Sebastián Pablo Chapela ◽  
Silvina de los Angeles Paz ◽  
Florencia Maria Ballestero
Keyword(s):  
Acute Pancreatitis ◽  
Gastrointestinal Tract ◽  
Pancreatic Lipase ◽  
Epigastric Pain ◽  
Drug Induced ◽  
Biliary Lithiasis ◽  
Pancreatic Parenchyma ◽  
Imaging Methods ◽  
Severe Intensity

Pancreatitis is one of the commonest diseases of the gastrointestinal tract, characterized by epigastric pain of moderate to severe intensity, which radiates to the back, elevation of pancreatic lipase and amylase enzymes, and changes in pancreatic parenchyma in imaging methods. The most common etiologies vary, generally the most frequent being biliary lithiasis and alcohol, followed by hypertriglyceridemia. Among the less frequent causes is drug-induced pancreatitis. We report a case of acute pancreatitis caused by cocaine, rarely described in literature.

scholarly journals Coronavirus Disease-19-associated Acute Pancreatitis: Report of Three Cases and Review of Case Reports

2021 ◽  
Vol 9 (C) ◽  
pp. 63-69
Author(s):  
Fahmi Yousef Khan ◽  
Theeb Osama Sulaiman ◽  
Arun Prabhakaran Nair ◽  
Mohamed Elmudathir Osman
Keyword(s):  
Acute Pancreatitis ◽  
Normal Limit ◽  
Serum Amylase ◽  
Epigastric Pain ◽  
Case Reports ◽  
Good Condition ◽  
Elevated Serum ◽  
Nausea And Vomiting ◽  
Severe Epigastric Pain ◽  
Pcr Test

BACKGROUND: Reports on coronavirus disease 2019 (COVID-19) associated with acute pancreatitis continue to emerge. In this series, we present three cases of acute pancreatitis associated with COVID-19 with no obvious etiology. CASE REPORTS: The first case was a 47-year-old man who presented with severe abdominal periumbilical pain, preceded by fever and dry cough. Based on a positive COVID-19 polymerase chain reaction (PCR) test and elevated serum amylase and lipase >3 times the upper normal limit, the diagnosis of COVID-19 and acute pancreatitis were established. The next case was a 57-year-old man with confirmed COVID-19 who developed severe epigastric pain radiating to the back and was associated with nausea and vomiting. His serum amylase and lipase were elevated >3 times the upper normal limit confirming the diagnosis of acute pancreatitis. The third case was a 31-year-old man who presented to the emergency department with a few hours of severe epigastric pain radiating to the back associated with nausea and vomiting. Two days before his presentation, he had a runny nose and fever. A combination of serum amylase and lipase elevation, >3 times the upper normal limits, and a positive COVID-19 PCR test were obtained concurrently, confirming the diagnosis of COVID-19 associated acute pancreatitis. All patients were admitted to the Mesaieed Hospital COVID-19 facility and received treatment for COVID-19 according to our local guidelines, while acute pancreatitis was treated conservatively. All three patients were discharged in good condition. CONCLUSION: This case series suggests a possible correlation between COVID-19 and acute pancreatitis.

scholarly journals Metronidazole-Induced Pancreatitis: Is There Underrecognition? A Case Report and Systematic Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Ibrahim Youssef ◽  
Naba Saeed ◽  
Mohammad El Abdallah ◽  
Kara Huevelhorst ◽  
Kais Zakharia
Keyword(s):  
Acute Pancreatitis ◽  
Epigastric Pain ◽  
Causative Factor ◽  
Drug Induced ◽  
Concurrent Use ◽  
The Usa ◽  
History Of ◽  
Fat Stranding ◽  
Supportive Management ◽  
Severe Epigastric Pain

Introduction. Acute pancreatitis (AP) is the most common cause of gastroenterological hospitalization in the USA, with a mortality ranging from 5 to 20%. Up to 80% of cases are caused by cholelithiasis and alcohol abuse. Less common etiologies that need to be explored include hypertriglyceridemia, trauma, ERCP, infections, and drugs. A number of medications are known to cause acute pancreatitis, with 0.3-1.4% of all cases of pancreatitis being drug induced (DIP). Here, we present a case of metronidazole-induced acute pancreatitis. Case Summary. A 60-year-old female presented with constant severe epigastric pain associated with nausea, vomiting, and anorexia for one day. She had no past medical history of alcohol use or hypertriglyceridemia and was s/p cholecystectomy in the distant past. Symptoms had begun three days after starting metronidazole for Clostridium difficile colitis. Lipase was > 396, and CT abdomen revealed peripancreatic fat stranding. She was diagnosed with AP, metronidazole was suspected to be responsible and hence stopped, and supportive management initiated. Her symptoms improved rapidly, and pancreatic enzymes normalized within 2 days. Of note, she had had an episode of acute pancreatitis 3 years ago, also following metronidazole use, with resolution at discontinuation of the drug. She had concurrently been on omeprazole during both episodes. Discussion. Metronidazole is a commonly used antibiotic and is infrequently reported as a cause of DIP. Our review suggests the possibility of a dose-response and duration-response effect between metronidazole use and occurrence of pancreatitis. The most common presenting symptom and sign was moderate to severe epigastric pain and tenderness, accompanied by nausea/vomiting. Symptoms usually start within 2-7 days of starting the medication and usually resolve 2-5 days after discontinuation of therapy and pancreatitis treatment. The most common causative dose was 1-1.5 g/day. Our review also supports findings by Norgaard et al. suggesting that concurrent use of omeprazole potentiates the risk of metronidazole-induced pancreatitis. Conclusion. Metronidazole is a commonly used antibiotic that may cause metronidazole-induced pancreatitis, especially if patients are concurrently taking PPIs. Awareness needs to be raised amongst clinicians regarding this association, in order to correctly identify etiology of pancreatitis and discontinue metronidazole promptly when suspected as the causative factor.

scholarly journals Ultrasonographic Monitoring in 38 Dogs with Clinically Suspected Acute Pancreatitis

2020 ◽  
Vol 7 (4) ◽  
pp. 180
Author(s):  
Federico Puccini Leoni ◽  
Tina Pelligra ◽  
Simonetta Citi ◽  
Veronica Marchetti ◽  
Eleonora Gori ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Retrospective Study ◽  
Clinical Examination ◽  
Pancreatic Lipase ◽  
Abdominal Ultrasound ◽  
Diagnostic Evaluation ◽  
Ultrasonographic Diagnosis ◽  
Study Population

Abdominal ultrasound examinations (AUEs) are commonly used in the diagnostic evaluation of canine acute pancreatitis (AP). The purpose of this retrospective study was to evaluate and monitor the ultrasonographic changes observed in dogs with clinically suspected AP on consecutive AUEs. The study population was constituted by 38 client-owned dogs hospitalized for no less than 48 h from January 2016 to December 2019. Dogs included in this study were suspected of AP based on the clinical examination and abnormal rapid specific canine pancreatic lipase test performed at admission. Dogs were submitted to two AUEs, the first on the first day of hospitalization, and the second between 40–52 h after the first one. Twelve dogs had both AUEs suggestive of AP. Fourteen dogs received an ultrasonographic diagnosis of AP exclusively on the second AUE. Twelve dogs remained negative on both the first and the second AUE. In 26 out of 38 patients the second AUE was suggestive of AP. If a patient is suspected of AP, it is advisable to carry out ultrasonographic monitoring at least within the first 52 h after admission, since ultrasonographic signs of AP may only become observable later after hospitalization.

scholarly journals The Management of Multi-Site, Bleeding, Visceral Artery Pseudoaneurysms, Secondary to Necrotising Pancreatitis

2009 ◽  
Vol 91 (3) ◽  
pp. 255-258 ◽  
Author(s):  
J Skipworth ◽  
D Raptis ◽  
D Brennand ◽  
C Imber ◽  
A Shankar
Keyword(s):  
Acute Pancreatitis ◽  
Epigastric Pain ◽  
Rare Complication ◽  
Enterocutaneous Fistula ◽  
Fistula Formation ◽  
Visceral Artery ◽  
Haemodynamic Instability ◽  
Successful Recovery ◽  
Necrotising Pancreatitis ◽  
Tomographic Angiography

We present the case of a 45-year-old man, who presented to his local casualty department with severe epigastric pain following an alcohol binge, and was subsequently diagnosed with acute pancreatitis. Pancreatic necrosis with multiple collections ensued, necessitating transfer to an intensive care unit (ITU) in a tertiary hepatopancreaticobiliary centre. Initially, the patient appeared to slowly improve and was discharged to the ward, albeit following a prolonged ITU admission. However, during his subsequent recovery, he suffered multiple episodes of haematemesis and melaena associated with haemodynamic instability and requiring repeat admission to the ITU. Computerised tomographic angiography, followed by visceral angiography, was used to confirm the diagnosis of multisite visceral artery pseudoaneurysms, secondary to severe, necrotising pancreatitis. Pseudoaneurysms of the splenic, left colic and gastroduodenal arteries were sequentially, and successfully, radiologically embolised over a period of 9 days. Subsequent sequelae of radiological embolisation included a clinically insignificant splenic infarct, and a left colonic infarction associated with subsequent enterocutaneous fistula formation. The patient made a prolonged, but successful, recovery and was discharged from hospital after 260 days as an in-patient. This case illustrates the rare complication of three separate pseudoaneurysms, secondary to acute pancreatitis, successfully managed radiologically in the same patient. This case also highlights the necessity for multidisciplinary involvement in the management of pseudoaneurysms, an approach that is often most successfully achieved in a tertiary setting.

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