一个强力霉素诱发胰腺炎的病例

Jeremiah Kakes, William E Cayley, Justin Sporleder
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摘要

导言:急性胰腺炎是美国住院治疗的常见病因,每年约有 23 万至 27.5 万人因此住院治疗:一名 64 岁的男性因急性上腹痛并向背部放射、脂肪酶为 6611(单位/升)和计算机断层扫描显示中度胰腺周围炎症而入院。他最近没有酗酒,胆囊在手术中没有切除,评估时也没有发现胆囊病变;不过,他在 10 天前开始服用强力霉素。住院期间,他因吸入性肺炎接受了止痛药、输液和抗生素治疗。除了出院两个月后出现轻微的间歇性腹痛外,他的急性症状已经缓解:讨论:据报道,强力霉素诱发的胰腺炎发生在用药后的 3 至 17 天内。鉴于时间上的相关性和缺乏其他诱发病因,我们认为最有可能的病因是强力霉素:要了解强力霉素诱发胰腺炎的病理生理学和发病率,还需要进一步研究。
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A Case of Doxycycline-Induced Pancreatitis.

Introduction: Acute pancreatitis is a common cause of hospitalizations in the United States, causing approximately 230 000 to 275 000 annual admissions We present the case of a patient with acute pancreatitis likely due to doxycycline.

Case presentation: A 64-year-old male was admitted after developing acute epigastric pain radiating to his back, a lipase of 6611 (units/L), and a computed tomography scan showing moderate peripancreatic inflammation. He had no recent alcohol use, his gallbladder was surgically absent, and he had no gallbladder pathology on evaluation; however, he had been started on doxycycline 10 days prior. While hospitalized, he was treated with pain medications, fluids, and antibiotics for aspiration pneumonia. His acute symptoms resolved, except for minor intermittent abdominal pain 2 months after discharge.

Discussion: Doxycycline-induced pancreatitis has been reported within 3 to 17 days of medication initiation. Given the temporal correlation and lack of other inciting etiologies, we determined the most likely etiology was doxycycline.

Conclusions: Further study is needed to understand the pathophysiology and incidence of doxycycline-induced pancreatitis.

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