Pentamidine-associated pancreatitis.

Two patients without risk factors or a prior history of pancreatitis developed acute pancreatitis soon after initiating pentamidine isethionate therapy for Pneumocystis carinii pneumonia associated with the acquired immunodeficiency syndrome. In both patients the pancreatitis improved following medication cessation. One patient did not redevelop pancreatitis when he subsequently received inhaled pentamidine. Review of the literature revealed five previously reported cases of this drug reaction. Pentamidine-associated pancreatitis appears to develop within three weeks of initiating therapy and after receiving more than 1 g in cumulative dosage. Glucose abnormalities, renal insufficiency, and non-specific abdominal pain may be early warning signs of pentamidine-associated pancreatitis.