Naxakis Stelios, Wafer Meghan, Collins Ruth
St. Michael's Unit, Mercy University Hospital, North Lee Mental Health Services, Cork, Ireland.
Gen Psychiatr. 2022 Mar 3;35(1):e100687. doi: 10.1136/gpsych-2021-100687. eCollection 2022.
A married mother in her 50s acutely developed vomiting, diarrhoea and severe epigastric pain 2 weeks following discharge from an acute psychiatric inpatient unit. She presented to the emergency department complaining of a 2-day history of the above symptoms. Blood tests revealed neutrophilia, grossly raised inflammatory markers and amylase levels triple the normal range. Based on radiological investigations, she was treated for necrotising pancreatitis that quickly escalated to multi-system organ failure and a lengthy intensive care unit admission. Common causes of pancreatitis, including cholelithiasis, alcohol and other drugs, were ruled out. Despite this, she suffered recurrent episodes of pancreatitis with significant morbidity. Olanzapine, started during her psychiatric admission, was determined to be the offending agent. Two years following the discontinuation of olanzapine, the patient has had no further episodes of acute pancreatitis.
一名50多岁的已婚母亲在急性精神科住院部出院2周后，突然出现呕吐、腹泻和严重的上腹部疼痛。她前往急诊科就诊，诉说有上述症状2天的病史。血液检查显示中性粒细胞增多、炎症标志物大幅升高且淀粉酶水平增至正常范围的三倍。基于影像学检查结果，她被诊断为坏死性胰腺炎并接受治疗，病情迅速发展为多系统器官衰竭，随后在重症监护病房住院很长时间。胰腺炎的常见病因，包括胆石症、酒精和其他药物，均被排除。尽管如此，她仍反复出现胰腺炎发作，且伴有严重的发病率。在她精神科住院期间开始使用的奥氮平被确定为致病因素。停用奥氮平两年后，患者未再出现急性胰腺炎发作。
