A rare case of acute pancreatitis: a diagnostic conundrum and unusual complications

2020 ◽  
Vol 93 (1) ◽  
pp. 1-5
Author(s):  
Bartłomiej Strzelec ◽  
Piotr Chmielewski ◽  
Martyna Strzelec ◽  
Renata Taboła
Keyword(s):  
Acute Pancreatitis ◽  
Rare Case ◽  
Good Condition ◽  
Serum Levels ◽  
Pancreatic Enzymes ◽  
First Episode ◽  
Surgical Ward ◽  
History Of ◽  
Idiopathic Acute Pancreatitis ◽  
Excessive Alcohol

A 63-year-old man with a history of recurrent idiopathic acute pancreatitis (AP) was admitted to our surgical ward due to severe abdominal pain. He denied chronic excessive alcohol use. Other typical causes of AP, such as gallstones, hypertriglyceridemia, and trauma, were ruled out. After considering all possible etiologies, the most likely factor producing AP was medication that had been administered to him two weeks before the very first episode of the disease. Medication should always be considered as a possible trigger of AP, especially if the first episode occurs shortly after drug administration and the etiology is unclear. During patient’s hospitalization, laboratory reports revealed significant fluctuations in the serum levels of pancreatic enzymes, which can be attributed to recurrent bacteremia. After the 30-day period of hospitalization and long-lasting antibiotic therapy, he was discharged in a good condition with normal levels of serum pancreatic enzymes.

A rare case of acute pancreatitis: a diagnostic conundrum and unusual complications

2020 ◽  
Vol 92 (5) ◽  
pp. 1-5
Author(s):  
Bartłomiej Strzelec ◽  
Piotr Chmielewski ◽  
Martyna Strzelec ◽  
Renata Taboła
Keyword(s):  
Acute Pancreatitis ◽  
Rare Case ◽  
Good Condition ◽  
Serum Levels ◽  
Pancreatic Enzymes ◽  
First Episode ◽  
Surgical Ward ◽  
History Of ◽  
Idiopathic Acute Pancreatitis ◽  
Excessive Alcohol

A 63-year-old man with a history of recurrent idiopathic acute pancreatitis (AP) was admitted to our surgical ward due to severe abdominal pain. He denied chronic excessive alcohol use. Other typical causes of AP, such as gallstones, hypertriglyceridemia, and trauma, were ruled out. After considering all possible etiologies, the most likely factor producing AP was medication that had been administered to him two weeks before the very first episode of the disease. Medication should always be considered as a possible trigger of AP, especially if the first episode occurs shortly after drug administration and the etiology is unclear. During patient’s hospitalization, laboratory reports revealed significant fluctuations in the serum levels of pancreatic enzymes, which can be attributed to recurrent bacteriemia. After the 30-day period of hospitalization and long-lasting antibiotic therapy, he was discharged in a good condition with normal levels of serum pancreatic enzymes.

scholarly journals Relationship between Gout and Diabetes Mellitus after Acute Pancreatitis: A Nationwide Cohort Study

2019 ◽  
Vol 47 (6) ◽  
pp. 917-923 ◽  
Author(s):  
Jaelim Cho ◽  
Nicola Dalbeth ◽  
Maxim S. Petrov
Keyword(s):  
Diabetes Mellitus ◽  
Acute Pancreatitis ◽  
Cox Regression ◽  
Social Deprivation ◽  
First Episode ◽  
Low Grade ◽  
Discharge Data ◽  
History Of ◽  
Low Grade Inflammation ◽  
The Relationship

Objective.After acute pancreatitis, individuals often have low-grade inflammation, and subsequently develop metabolic sequelae such as post-pancreatitis diabetes mellitus (PPDM). Although numerous studies have investigated the relationship between gout and type 2 diabetes, little is known about the relationship between gout and PPDM. The aim was to investigate the associations between gout and PPDM.Methods.Using nationwide pharmaceutical dispensing data linked to hospital discharge data in New Zealand, gout and PPDM were identified among individuals after first episode of acute pancreatitis between January 1, 2007, and December 31, 2015. Multivariable Cox regression analyses were conducted, adjusting for age, sex, ethnicity, social deprivation index, alcohol consumption, tobacco smoking, comorbidities, medications (glucocorticoids, statins, and estrogens), and characteristics of acute pancreatitis.Results.A total of 10,117 individuals were included in the analysis of risk for gout and 9471 in the analysis of risk for PPDM. PPDM was significantly associated with a higher risk of gout in the overall cohort (adjusted HR 1.88, 95% CI 1.15–3.06) and women (2.72, 95% CI 1.31–5.65), but not in men (1.42, 95% CI 0.73–2.78). Preexisting gout was significantly associated with a higher risk of PPDM in the overall cohort (adjusted HR 1.58, 95% CI 1.04–2.41) and women (2.66, 95% CI 1.29–5.49), but not in men (1.31, 95% CI 0.78–2.20).Conclusion.The relationship between gout and PPDM is bidirectional in the post-pancreatitis setting. A history of gout is a risk factor of PPDM, particularly in women.

Outcomes, risk of recurrence and chronic pancreatitis after a first episode of idiopathic acute pancreatitis: a retrospective cohort study

Pancreatology ◽  
2019 ◽  
Vol 19 ◽  
pp. S182
Author(s):  
A. García García de Paredes ◽  
E. Sánchez Rodríguez ◽  
C. González Olivares ◽  
E. Rodríguez de Santiago ◽  
J. Martínez ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Cohort Study ◽  
Chronic Pancreatitis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
First Episode ◽  
Risk Of Recurrence ◽  
Idiopathic Acute Pancreatitis

Association of NF-κB with Recurrence of Myocardial Infarction- A Study in North Indian Population

2021 ◽  
Author(s):  
Sana Tasnim
Keyword(s):  
Myocardial Infarction ◽  
Family History ◽  
Disease Risk ◽  
Vascular Inflammation ◽  
Previous History ◽  
Serum Levels ◽  
First Episode ◽  
History Of ◽  
Plaque Destabilization ◽  
First Time

Background: Nuclear factor kappa beta (NF-κB) is a decisive transcription factor associated with vascular inflammation which is responsible for plaque destabilization and rupture. Objective: The present study aims to evaluate its levels in patients with recurrent Myocardial Infarction (MI) as compared to controls. Methods: To understand the mechanism of familial susceptibility we decided to study the levels of NF-κB. We enrolled 200 patients after detailed diagnosis, sub-grouping and consideration of inclusion and exclusion criteria. The study subjects were segregated into patients without family history and patients having family history of MI. Patients without family history were further sub-grouped into patients who had MI for the first time (n=63) and patients who had recurrentMI (n=37). Also, patients with family history of MI were further sub-grouped into patients who had MI for the first time (n=54) and patients who had recurrent MI (n=46). Serum NF-κB was estimated by ELISA. Results: Study subjects having recurrent episodes of MI had significantly higher level of NF-κB as compared to those who had first episode of MI (p=0.0018). Serum levels of NF-κB were significantly raised in patients with family history having first episode of MI when compared with those patients without family history (p=0.0007). Conclusions: The study suggests that NF-κB activation is pivotal in triggering coronaryinstability and causing recurrence in patients with previous history of unstable angina. Furthermore, family history can increase the susceptibility to increased CAD (Coronary Artery Disease) risk due to raised NF-κB levels in these patients as compared to those without family history.

scholarly journals Role of endoscopic ultrasonography in the diagnostic work-up of idiopathic acute pancreatitis (PICUS): study protocol for a nationwide prospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e035504
Author(s):  
Devica S Umans ◽  
Hester C Timmerhuis ◽  
Nora D Hallensleben ◽  
Stefan A Bouwense ◽  
Marie-Paule GF Anten ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Cohort Study ◽  
Magnetic Resonance ◽  
Endoscopic Ultrasonography ◽  
Medical Center ◽  
First Episode ◽  
Idiopathic Acute Pancreatitis ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

IntroductionIdiopathic acute pancreatitis (IAP) remains a dilemma for physicians as it is uncertain whether patients with IAP may actually have an occult aetiology. It is unclear to what extent additional diagnostic modalities such as endoscopic ultrasonography (EUS) are warranted after a first episode of IAP in order to uncover this aetiology. Failure to timely determine treatable aetiologies delays appropriate treatment and might subsequently cause recurrence of acute pancreatitis. Therefore, the aim of the Pancreatitis of Idiopathic origin: Clinical added value of endoscopic UltraSonography (PICUS) Study is to determine the value of routine EUS in determining the aetiology of pancreatitis in patients with a first episode of IAP.Methods and analysisPICUS is designed as a multicentre prospective cohort study of 106 patients with a first episode of IAP after complete standard diagnostic work-up, in whom a diagnostic EUS will be performed. Standard diagnostic work-up will include a complete personal and family history, laboratory tests including serum alanine aminotransferase, calcium and triglyceride levels and imaging by transabdominal ultrasound, magnetic resonance imaging or magnetic resonance cholangiopancreaticography after clinical recovery from the acute pancreatitis episode. The primary outcome measure is detection of aetiology by EUS. Secondary outcome measures include pancreatitis recurrence rate, severity of recurrent pancreatitis, readmission, additional interventions, complications, length of hospital stay, quality of life, mortality and costs, during a follow-up period of 12 months.Ethics and disseminationPICUS is conducted according to the Declaration of Helsinki and Guideline for Good Clinical Practice. Five medical ethics review committees assessed PICUS (Medical Ethics Review Committee of Academic Medical Center, University Medical Center Utrecht, Radboud University Medical Center, Erasmus Medical Center and Maastricht University Medical Center). The results will be submitted for publication in an international peer-reviewed journal.Trial registration numberNetherlands Trial Registry (NL7066). Prospectively registered.

Role of endoscopic ultrasonography in patients with first episode of idiopathic acute pancreatitis

2013 ◽  
Vol 33 (3) ◽  
pp. 241-248 ◽  
Author(s):  
Anurag Govil ◽  
Mahendra Kumar Agrawal ◽  
Dinesh Agrawal ◽  
Harsh Udawat
Keyword(s):  
Acute Pancreatitis ◽  
Endoscopic Ultrasonography ◽  
First Episode ◽  
Idiopathic Acute Pancreatitis

scholarly journals A case of acute pancreatitis with normal serum lipase

2016 ◽  
Vol 43 (3) ◽  
pp. 162-164
Author(s):  
Afroja Alam ◽  
Mohammad Ferdous Ur Rahman ◽  
Mahbubur Rahman ◽  
Abed Hussain Khan ◽  
Mohammad Mainul Hasan Chowdhury ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Case History ◽  
Epigastric Pain ◽  
Normal Serum ◽  
Pancreatic Enzymes ◽  
Middle Aged ◽  
Serum Lipase ◽  
History Of

Patients with acute pancreatitis typically present with epigastric pain. In such patients, demonstration of elevated pancreatic enzymes and swollen pancreas by radiological investigations are sufficient to confirm the diagnosis. Here we present case history of a middle aged man who had epigastric pain, fever and swollen pancreas but enzyme levels were normal. He responded to conventional conservative treatment.Bangladesh Med J. 2014 Sep; 43 (3): 162-164

scholarly journals An Unusual Case of Drug-Induced Acute Pancreatitis

2016 ◽  
Vol 30 (1&2) ◽  
pp. 26
Author(s):  
Andrea Vo ◽  
Stanley Yakubov ◽  
Colleen Smith ◽  
Mark Tratenberg ◽  
Elizabeth Sedlis-Singer ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Rare Case ◽  
Unusual Case ◽  
Causal Link ◽  
Drug Induced ◽  
Antidiabetic Therapy ◽  
Patient Reported ◽  
History Of ◽  
Relationship Of

We report a rare case of drug-induced pancreatitis in a patient receiving repaglinide antidiabetic therapy. A patient with type 2 diabetes mellitus presented with severe abdominal cramping, nausea, and vomiting. Three months prior to symptoms, repaglinide was added to the patient’s current regimen of metformin. The patient was diagnosed with acute pancreatitis, treatment was initi- ated, and repaglinide was discontinued. There was no history of pancreatitis or other risk factors such as history of gallstones, alcohol abuse, or hypertriglyceridemia. The patient reported resolution of symptoms following discontinuation of repaglinide. Considering the temporal relationship of his symptoms to the addition of repaglinide to his existing antidiabetic regimen, this case strongly suggests a possible causal link between repaglinide and the etiology of acute pancreatitis in this patient. 

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