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对乙酰氨基酚所致急性胰腺炎。病例报告。

Acetaminophen-induced acute pancreatitis. A case report.

作者信息

Igarashi Hisato, Ito Tetsuhide, Yoshinaga Masahiro, Oono Takamasa, Sakai Hiroyuki, Takayanagi Ryoichi

机构信息

Department of Gastroenterology, National Hospital Organization, Beppu Medical Center, Beppu, Japan.

出版信息

JOP. 2009 Sep 4;10(5):550-3.

Abstract

CONTEXT

Drug-induced acute pancreatitis is rare but should not be overlooked in a patient who presents with idiopathic acute pancreatitis. More than 100 drugs have been implicated in causing the disease: acetaminophen has been associated with acute pancreatitis in cases where there has been an overdose of drugs; however, the frequency is rare.

CASE REPORT

We report the case of a 35-year-old woman who presented with acute pancreatitis and severe metabolic acidosis after overdosing on a drug containing acetaminophen. She improved dramatically after intensive care; however, she showed recurrent episodes after re-overdosing on the same drug. With her self re-challenge test, she was diagnosed as having acetaminophen-induced pancreatitis and metabolic acidosis. A review of the relevant literature is also presented.

CONCLUSIONS

Drug-induced acute pancreatitis is often challenging for clinicians and a detailed mechanism is unknown. It is very important to rule out drug-induced pancreatitis when treating pancreatitis with an unknown etiology.

摘要

背景

药物性急性胰腺炎较为罕见,但在出现特发性急性胰腺炎的患者中不应被忽视。已有100多种药物被认为可导致该病:对乙酰氨基酚在药物过量的情况下与急性胰腺炎有关;然而,其发生率很低。

病例报告

我们报告了一名35岁女性的病例,该患者在过量服用含对乙酰氨基酚的药物后出现急性胰腺炎和严重代谢性酸中毒。经过重症监护,她的病情显著改善;然而,在再次过量服用同一药物后,她出现了复发。通过自我再激发试验,她被诊断为对乙酰氨基酚诱导的胰腺炎和代谢性酸中毒。本文还对相关文献进行了综述。

结论

药物性急性胰腺炎对临床医生来说往往具有挑战性,其详细机制尚不清楚。在治疗病因不明的胰腺炎时,排除药物性胰腺炎非常重要。

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