Kunjathaya Purnima, Ramaswami Pradeep Kakkadasam, Krishnamurthy Anupama Nagar, Bhat Naresh
Department of Gastroenterology, Columbia Asia Referral Hospital, Bangalore, India.
JOP. 2013 Jan 10;14(1):81-4. doi: 10.6092/1590-8577/1203.
To report a case of acute necrotizing pancreatitis in a patient receiving vildagliptin.
A 49-year-old man presented to us with severe abdominal pain and was diagnosed to have pancreatitis three weeks after the commencement of vildagliptin for the treatment of uncontrolled type 2 diabetes mellitus. His serum amylase was 2,215 U/L at admission, with contrast enhanced computed tomography (CECT) of the abdomen and pelvis showing features of acute pancreatitis. The patient had a prolonged hospital course and underwent laparoscopic pancreatic necrosectomy to relieve him of his biliary obstruction and an endoscopic retrograde cholangiopancreatography (ERCP) and biliary stenting as he had an avulsion of the cystic duct during surgery.
Acute pancreatitis as a complication of other incretin-based therapy like sitagliptin and exenatide is known and well reported, and has prompted the US Food and Drug Administration to issue an alert on these drugs. This appears to be the first reported case of acute necrotizing pancreatitis in a patient receiving vildagliptin in India and reinforces the need to be more judicious in the use of this medication.
报告一例接受维格列汀治疗的患者发生急性坏死性胰腺炎的病例。
一名49岁男性因严重腹痛前来就诊，在开始使用维格列汀治疗未控制的2型糖尿病三周后被诊断为胰腺炎。入院时其血清淀粉酶为2215 U/L，腹部和盆腔增强CT显示急性胰腺炎特征。该患者住院病程较长，因手术中胆囊管撕脱，接受了腹腔镜胰腺坏死组织清除术以解除胆道梗阻，并进行了内镜逆行胰胆管造影（ERCP）和胆道支架置入术。
急性胰腺炎作为西他列汀和艾塞那肽等其他基于肠促胰岛素的治疗的并发症已为人所知且有充分报道，这促使美国食品药品监督管理局对这些药物发出警报。这似乎是印度首例关于接受维格列汀治疗的患者发生急性坏死性胰腺炎的报告病例，强化了更谨慎使用该药物的必要性。
