Diuretics-Induced Acute Pancreatitis: Case Series with a Review of the Literature.

IF 1.1 Q4 PHARMACOLOGY & PHARMACY Current drug safety Pub Date : 2024-10-02 DOI:10.2174/0115748863324787240916114833

Dhruvkumar M Patel, Maitri M Patel, Lalitkumar B Patel, Vahin B Patel, Mukundkumar V Patel, Dhara K Patel

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Abstract

Background: Although diuretic-induced Acute Pancreatitis (AP) cases are typically mild to moderate, severe and potentially fatal occurrences can arise. Case Series and Literature Review: We have, herein, presented a series of diuretic-induced AP cases from March 2018 to February 2024 of a 54-year-old woman treated with chlorthalidone, a 45-year-old male treated with hydrochlorothiazide, and a 48-year-old male treated with frusemide. The literature search has identified 26 cases published to date, 10 from frusemide and 16 from thiazide diuretics. The Naranjo adverse reaction probability scale has categorized all three drugs as "probable". All cases have responded to conservative treatment and cessation of the offending drug. Various mechanisms, such as hypersensitization, ischemia, direct cytotoxic effects, hypercalcemia, and dose-dependent idiosyncrasy, have been found to lead to intrapancreatic activation of pancreatic enzymes, resulting in drug-induced AP.

Conclusion: Further research into the mechanisms and genetic factors contributing to diureticinduced AP is essential for enabling early diagnosis and management of diuretic-induced AP.

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利尿剂诱发的急性胰腺炎：病例系列及文献综述。

背景：虽然利尿剂诱发的急性胰腺炎（AP）病例通常为轻度至中度，但也可能出现严重的致命病例。病例系列和文献综述：我们在此介绍了 2018 年 3 月至 2024 年 2 月期间的一系列利尿剂诱发 AP 病例，其中包括一名使用氯沙坦治疗的 54 岁女性、一名使用氢氯噻嗪治疗的 45 岁男性和一名使用氟塞米治疗的 48 岁男性。通过文献检索发现，迄今为止已发表了 26 个病例，其中 10 例来自氟塞米，16 例来自噻嗪类利尿剂。纳兰霍不良反应概率表将这三种药物都归类为 "可能"。所有病例均对保守治疗和停用违规药物有反应。已发现多种机制，如过敏、缺血、直接细胞毒性作用、高钙血症和剂量依赖性特异性，可导致胰酶在胰腺内活化，从而导致药物诱发 AP：结论：进一步研究导致利尿剂诱发 AP 的机制和遗传因素对于早期诊断和治疗利尿剂诱发 AP 至关重要。

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来源期刊

Current drug safety PHARMACOLOGY & PHARMACY-

CiteScore

2.10

自引率

0.00%

发文量

112

期刊介绍： Current Drug Safety publishes frontier articles on all the latest advances on drug safety. The journal aims to publish the highest quality research articles, reviews and case reports in the field. Topics covered include: adverse effects of individual drugs and drug classes, management of adverse effects, pharmacovigilance and pharmacoepidemiology of new and existing drugs, post-marketing surveillance. The journal is essential reading for all researchers and clinicians involved in drug safety.