Kim Hong Jun, Han Jae Joon, Maeng Chi Hoon, Baek Sun Kyung
Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
Int J Gen Med. 2020 Sep 24;13:699-704. doi: 10.2147/IJGM.S272375. eCollection 2020.
Lenvatinib, a novel multi-target tyrosine kinase inhibitor, has been approved for treating differentiated thyroid cancer. Herein, we describe a rare case of acute pancreatitis that developed during lenvatinib treatment in a 65-year-old man with recurrent thyroid cancer.
The patient was admitted to our department following a complaint of acute-onset epigastric pain and indigestion. He had been receiving lenvatinib since 34 days. Although his serum amylase and lipase levels were normal, he had acute-onset persistent epigastric pain and typical computed tomography findings, which were consistent with those of acute pancreatitis. As other common etiologies were excluded, it was concluded that the patient had lenvatinib-induced acute pancreatitis. On admission day 14, he could consume food orally, after conservative care, including drug cessation, intravenous hydration, and pain control.
Physicians should consider acute pancreatitis as a differential diagnosis for patients complaining of abdominal pain while on lenvatinib, regardless of hyperamylasemia or hyperlipasemia. Systematic collection of data on acute pancreatitis development during lenvatinib treatment should be considered, and further research is warranted to identify the mechanism of acute pancreatitis associated with multi-target tyrosine kinase inhibitors such as lenvatinib.
仑伐替尼是一种新型多靶点酪氨酸激酶抑制剂，已被批准用于治疗分化型甲状腺癌。在此，我们描述了一例65岁复发性甲状腺癌男性患者在接受仑伐替尼治疗期间发生急性胰腺炎的罕见病例。
患者因突发上腹部疼痛和消化不良入院。他自34天前开始接受仑伐替尼治疗。尽管其血清淀粉酶和脂肪酶水平正常，但他出现了急性发作的持续性上腹部疼痛和典型的计算机断层扫描结果，这些结果与急性胰腺炎相符。由于排除了其他常见病因，得出该患者为仑伐替尼诱导的急性胰腺炎的结论。在入院第14天，经过包括停药、静脉补液和疼痛控制在内的保守治疗后，他能够经口进食。
医生在仑伐替尼治疗期间，对于主诉腹痛的患者，无论是否存在高淀粉酶血症或高脂血症，均应将急性胰腺炎作为鉴别诊断之一。应考虑系统收集仑伐替尼治疗期间急性胰腺炎发生的数据，并且有必要进行进一步研究以确定与仑伐替尼等多靶点酪氨酸激酶抑制剂相关的急性胰腺炎的机制。
