DRUG INDUCED ACUTE SEVERE NECROTISING PANCREATITIS

Nishi Somarkutty*, Bincy Charley, Bobby Abraham, Chepsy C. Philip and Deepak K. Johnson

ABSTRACT

Acute necrotizing pancreatitis is a life threatening form of acute pancreatitis and is characterised by inflammation associated with pancreatic parenchymal necrosis or peripancreatic necrosis. After alcohol and gallstones are ruled out, drug-induced pancreatitis (DIP), which accounts for up to 5% of all acute pancreatitis cases, is the third most common cause of acute pancreatitis. Drug-induced pancreatitis affects around 5-80 persons worldwide per 100,000. In addition to youngsters, the elderly, and those with inflammatory bowel disease, DIP has been observed to be greater in people who are immunosuppressed. Didanosine, Azathioprine, Valproic acid, Mercaptopurine, Mesalamine, Tetracycline, Steroids, Furosemide, etc. are the medications most frequently documented to cause acute pancreatitis (those in which reaction reappeared after challenge dechallenge-rechallenge). However, other drugs like Rifampin, Erythromycin, Octreotide and several others have also been known to cause acute pancreatitis. In this case report we present the case of a 17 year old female patient who developed acute severe necrotizing pancreatitis following treatment with Azathioprine, Eltrombopag and Prednisolone for Immune thrombocytopenic purpura (ITP).

Keywords: Eltrombopag, Azathioprine, Prednisolone, Acute Necrotizing Pancreatitis, Immune Thrombocytopenic Purpura.