Internal Medicine, Saint Joseph Mercy Ann Arbor Hospital, Ann Arbor, Michigan, USA
Internal Medicine, Saint Joseph Mercy Ann Arbor Hospital, Ann Arbor, Michigan, USA.
BMJ Case Rep. 2021 Nov 19;14(11):e246720. doi: 10.1136/bcr-2021-246720.
Viral-induced pancreatitis has been well-defined; however, there are limited data regarding COVID-19 and pancreatitis. Most cases are commonly in conjunction with severe COVID-19 as well as lipase elevation. We describe a unique case of mild SARS-CoV-2 infection resulting in acute pancreatitis in the absence of lipase elevation. A 39-year-old patient with no medical history, presented with epigastric pain. Vital signs were unremarkable. Patient was positive for COVID-19. Liver function panel, calcium, triglyceride and lipase levels were all unremarkable. CT of the abdomen demonstrated acute pancreatitis without gallstones. Our case may indicate that pancreatic injury in SARS-CoV-2 infection is due to a direct impact on the pancreas by the virus, given the absence of lipase elevation and mild presentation. This case highlights the importance of suspecting pancreatitis in mild COVID-19 that present with atypical symptoms such as epigastric pain, even without lipase elevation.
病毒引起的胰腺炎已有明确的定义;然而,关于 COVID-19 和胰腺炎的数据有限。大多数病例通常与严重的 COVID-19 以及脂肪酶升高有关。我们描述了一例独特的轻度 SARS-CoV-2 感染导致急性胰腺炎的病例,该病例脂肪酶没有升高。一名 39 岁的患者无病史,表现为上腹痛。生命体征无异常。患者 COVID-19 检测呈阳性。肝功能、钙、甘油三酯和脂肪酶水平均无异常。腹部 CT 显示急性胰腺炎,无胆结石。我们的病例可能表明,SARS-CoV-2 感染中的胰腺损伤是由于病毒对胰腺的直接影响,因为脂肪酶没有升高且临床表现较轻。该病例强调了在表现为非典型症状(如上腹痛)的轻度 COVID-19 中怀疑胰腺炎的重要性,即使脂肪酶没有升高。