Neto Gonçalves Tiago, Sousa Débora, Marto Natália, Horta Alexandra Bayão
Internal Medicine Department, Hospital da Luz Lisboa, Lisbon, PRT.
Cureus. 2021 Feb 12;13(2):e13301. doi: 10.7759/cureus.13301.
Drug-induced pancreatitis is a rare entity accounting for less than 2% of acute pancreatitis (AP). Quinolones are commonly used antimicrobials with occasional reports of pancreatitis. We present the case of a 74-year-old man who was diagnosed with acute cystitis five days before hospital admission and was treated with levofloxacin (LVF). Two days after initiating LVF he experienced fever, severe abdominal pain, and nausea. The initial assessment revealed leukocytosis, elevated C-reactive protein, and a significant elevation of amylase and lipase. On abdominal ultrasound, the head of the pancreas revealed an hypoechogenic region suggestive of inflammatory edema. A diagnosis of AP was established. The drug was withdrawn along with supportive care, with complete resolution of the symptoms. No other probable causes of AP were found after further investigation. Although rare, LVF-induced pancreatitis should be considered when managing a patient with AP. Increasing physician awareness is vital to the prompt recognition of this entity.
药物性胰腺炎是一种罕见疾病，占急性胰腺炎（AP）的比例不到2%。喹诺酮类药物是常用抗菌药物，偶尔有引发胰腺炎的报道。我们报告一例74岁男性病例，该患者入院前5天被诊断为急性膀胱炎，并接受左氧氟沙星（LVF）治疗。开始使用LVF两天后，他出现发热、严重腹痛和恶心。初步评估显示白细胞增多、C反应蛋白升高，淀粉酶和脂肪酶显著升高。腹部超声检查显示胰腺头部有一个低回声区域，提示炎性水肿。确诊为AP。停用该药物并给予支持治疗后，症状完全缓解。进一步检查未发现其他可能导致AP的原因。虽然罕见，但在治疗AP患者时应考虑LVF诱发的胰腺炎。提高医生的认识对于及时识别这一疾病至关重要。
