Abhilash Kundavaram Paul Prabhakar, Ahmed Atif Shaikh Iqbal, Sathyendra Sowmya, Abraham Ooriapadickal Cherian
Department of General Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
J Family Med Prim Care. 2016 Jul-Sep;5(3):691-694. doi: 10.4103/2249-4863.197302.
Malaria is endemic in large parts of India and can cause multiorgan failure and death. Acute pancreatitis as a complication is rare and is potentially fatal. This case series describes five adult patients between 2005 and 2010 who presented with a short duration febrile illness and diagnosed to have malaria with acute pancreatitis. The mean age of the five patients with acute pancreatitis was 40.4 years and four of them were males. None of them were alcohol consumers and did not have any other risk factor for acute pancreatitis. was responsible for all the cases. Pancreatic enzymes were significantly elevated in all the patients with a mean serum lipase level of 1795 U/L (normal value: <190 U/L) and a mean serum amylase level of 584 U/L (normal value: <100 U/L). Ultrasonography evidence of acute pancreatitis (bulky pancreas) was seen in two patients, and a further two patients had minimal left-sided pleural effusion. Thrombocytopenia (platelet count <100,000/cumm), renal dysfunction (serum creatinine >1.4 mg/dl), and hyperbilirubinemia were seen in all the patients. One patient died due to multiorgan failure. Acute pancreatitis is a very rare complication of malaria, and a high index of suspicion is required in patients presenting with severe malaria and abdominal pain.
疟疾在印度大部分地区呈地方性流行，可导致多器官功能衰竭和死亡。急性胰腺炎作为一种并发症较为罕见，但有潜在致命性。本病例系列描述了2005年至2010年间5例成年患者，他们均出现病程较短的发热性疾病，被诊断为疟疾合并急性胰腺炎。5例急性胰腺炎患者的平均年龄为40.4岁，其中4例为男性。他们均无饮酒史，也没有其他急性胰腺炎的危险因素。所有病例均由[原文此处缺失信息]引起。所有患者的胰腺酶均显著升高，平均血清脂肪酶水平为1795 U/L（正常值：<190 U/L），平均血清淀粉酶水平为584 U/L（正常值：<100 U/L）。2例患者超声检查有急性胰腺炎证据（胰腺肿大），另外2例患者有少量左侧胸腔积液。所有患者均出现血小板减少（血小板计数<100,000/cumm）、肾功能不全（血清肌酐>1.4 mg/dl）和高胆红素血症。1例患者因多器官功能衰竭死亡。急性胰腺炎是疟疾非常罕见的并发症，对于出现重症疟疾和腹痛的患者需要高度怀疑。
