Bowers Riley D, Valanejad Sara M, Holombo Ashley A
Department of Pharmacy Practice, Campbell University College of Pharmacy and Health Sciences, Buies Creek, NC, USA.
Duke Regional Hospital, Durham, NC, USA.
J Pharm Pract. 2019 Oct;32(5):586-588. doi: 10.1177/0897190018760645. Epub 2018 Feb 27.
Acute pancreatitis has numerous etiologies, with the most common including gallstones, alcohol abuse, and medications such as angiotensin-converting enzyme (ACE) inhibitors, statins, and diuretics. Mirtazapine has been associated with increased serum cholesterol and serum triglyceride levels. However, few studies have reported dangerously elevated triglyceride levels resulting in acute pancreatitis. This report discusses a case of mirtazapine-induced pancreatitis in a 46-year-old African American female. The patient presented to the emergency department with pancreatitis, presumably alcohol-induced as with a prior admission, but she denied any recent alcohol use. Mirtazapine then became the suspected cause of her hypertriglyceridemia-induced pancreatitis and was discontinued. After discontinuing mirtazapine, and utilizing an insulin infusion, her triglyceride levels normalized and symptoms of pancreatitis resolved. Using the Naranjo Adverse Drug Reaction Probability Scale, a total score of 5 was calculated indicating a probable adverse drug reaction of acute pancreatitis from mirtazapine.
急性胰腺炎有多种病因，最常见的包括胆结石、酗酒以及药物，如血管紧张素转换酶（ACE）抑制剂、他汀类药物和利尿剂。米氮平与血清胆固醇和血清甘油三酯水平升高有关。然而，很少有研究报告甘油三酯水平危险升高导致急性胰腺炎。本报告讨论了一例46岁非裔美国女性因米氮平诱发胰腺炎的病例。该患者因胰腺炎就诊于急诊科，之前一次入院时推测为酒精所致，但她否认近期饮酒。随后米氮平成为她高甘油三酯血症诱发胰腺炎的疑似病因并被停用。停用米氮平并使用胰岛素输注后，她的甘油三酯水平恢复正常，胰腺炎症状也得到缓解。使用纳兰霍药物不良反应概率量表计算得出总分5分，表明米氮平可能导致急性胰腺炎这一药物不良反应。
