1 Department of Surgery, Seoul Medical Center, Seoul, Korea ; 2 Department of Surgery, Red Cross Hospital, Seoul, Korea.
Chin J Cancer Res. 2014 Jun;26(3):341-4. doi: 10.3978/j.issn.1000-9604.2014.05.01.
The side effects of tamoxifen are generally mild, including the effect on lipoprotein metabolism. However, there are few cases of severe tamoxifen induced hypertriglyceridemia. Hypertriglyceridemia is a marked risk factor for acute pancreatitis and approximately 2% to 5% of cases of acute pancreatitis are related to drugs. We report on tamoxifen-induced hypertriglyceridemia and acute pancreatitis in a 40 years old woman with type 2 diabetes mellitus occurred by dexamethasone. She was treated with insulin infusion and fenofibrate, and goserelin acetate was started instead of tamoxifen after discharge from the hospital. Also, probable pathogenic hypotheses about the correlation between tamoxifen and dexamethasone induced type 2 diabetes mellitus on severe acute pancreatitis are provided. Clinicians should take care of risks of severe acute pancreatitis on using tamoxifen, especially for patients with dexamethasone induced diabetes mellitus. These individuals should undergo pre-post tamoxifen lipid screening and careful history taking of drugs, including dexamethasone.
他莫昔芬的副作用通常较轻，包括对脂蛋白代谢的影响。然而，严重的他莫昔芬诱导的高甘油三酯血症病例较少。高甘油三酯血症是急性胰腺炎的一个显著危险因素，约 2%至 5%的急性胰腺炎与药物有关。我们报告了一例 40 岁患有 2 型糖尿病的女性，因地塞米松而发生他莫昔芬诱导的高甘油三酯血症和急性胰腺炎。她接受胰岛素输注和非诺贝特治疗，出院后开始使用醋酸戈舍瑞林代替他莫昔芬。此外，还提供了关于他莫昔芬和地塞米松诱导的 2 型糖尿病与严重急性胰腺炎之间相关性的可能发病假说。临床医生在使用他莫昔芬时应注意严重急性胰腺炎的风险，尤其是对于地塞米松诱导的糖尿病患者。这些患者应在使用他莫昔芬前后进行血脂筛查，并仔细询问药物史，包括地塞米松。
