38例药物性胰腺炎的研究

Medicina clinica (English ed.) Pub Date : 2024-12-13 Epub Date: 2024-10-31 DOI:10.1016/j.medcle.2024.07.010
Adrià Domingo-Carnice , Dolores Rodríguez , Pilar Ordoñez , Roser Llop , Silvia Salord , Pilar Hereu
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摘要

急性胰腺炎(AP)是一种多种病因的炎症性疾病,并出现并发症。0.1%-5%的病例与药物有关。由于缺乏特异性特征,使得药物性AP的诊断和治疗复杂化。回顾诊断为药物性AP的住院患者可以提供信息并改善其管理。患者和方法:这是一项描述性、观察性和回顾性研究。所有在2007年6月至2023年3月期间入住Universitari de Bellvitge医院(HUB)的疑似药物性AP患者均被纳入研究。数据来自HUB药物警戒项目数据库。结果共检出疑似药物性AP 38例,占adr总数的0.62% (n = 6085)。其中65.8% (n = 25)有单一可疑药物。不良反应发生的中位潜伏期为160.5天(IQR 18 ~ 582天),中位住院时间为5天(IQR 3 ~ 7天)。鉴定出疑似药物59种,涉及活性原理26种。硫唑嘌呤和阿托伐他汀最常见,各9例(15.2%),依那普利次之,8例(13.6%)。23例(60.5%)进行了药物病因评估,所有病例均停药。死亡1例(2.63%)。结论本研究有助于加深对药物性胰腺炎发作的认识。我们建议创建一个诊断算法,包括评估药物作为一个可能的原因。
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Drug-induced pancreatitis: Study of 38 patients

Introduction

Acute pancreatitis (AP) is an inflammatory disease with multiple etiologies, and the emergence of complications. Between 0.1%–5% of cases are attributed to drugs. The absence of specific characteristics complicates the diagnosis and treatment of drug-induced AP. Reviewing patients admitted with the diagnosis of drug-induced AP can provide information and improve its management.

Patients and methods

This is a descriptive, observational, and retrospective study. All patients admitted to the Hospital Universitari de Bellvitge (HUB) between June 2007 and March 2023 with suspected drug-induced AP were included. The data were obtained from the HUB pharmacovigilance program database.

Results

Thirty-eight patients with suspected drug-induced AP were identified, representing 0.62% of all adverse drug reactions (ADRs) (n = 6085). Of these, 65.8% (n = 25) had a single suspected drug. The median latency period for the onset of ADRs was 160.5 days (IQR 18–582 days), and the median hospital stay was 5 days (IQR 3–7 days). Fifty-nine suspected drugs were identified, involving 26 active principles. Azathioprine and atorvastatin were the most frequent, with 9 cases each (15.2%), followed by enalapril with 8 cases (13.6%). Drug etiology was assessed in 23 cases (60.5%), and the suspected drug was discontinued in all cases. There was 1 fatal case documented (2.63%).

Conclusion

This study can contribute to better understanding of drug-induced pancreatitis episodes. We propose the creation of a diagnostic algorithm that includes the assessment of the drug as a possible cause.
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