Ding Yixuan, Qu Chang, He Huan, Cao Feng, Ou Tongwen, Li Fei
Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Clinical Center for Acute Pancreatitis, Capital Medical University, Beijing, China.
Front Med (Lausanne). 2022 Apr 21;9:843870. doi: 10.3389/fmed.2022.843870. eCollection 2022.
Drug-induced pancreatitis is a rare cause of acute pancreatitis. Tacrolimus has been used as an immunosuppressant agent in patients after organ transplantation. However, only a few case reports of tacrolimus-induced acute pancreatitis in kidney transplantation have been reported. The purpose of this case report is to alert clinicians that tacrolimus-induced acute pancreatitis may occur during tacrolimus therapy in kidney transplant patients.
We present the case of a 38-year-old woman who underwent kidney transplantation and received immunosuppressive therapy with tacrolimus; on day 20 post-transplantation, she presented with acute abdominal pain in the middle and left areas of the abdomen accompanied by diarrhea, nausea, and vomiting. We excluded gallstone disease, alcohol, hypertriglyceridemia, and other possible causes, and speculated that tacrolimus was the probable cause of pancreatitis because of the extremely high blood concentration of tacrolimus. After tacrolimus was changed to cyclosporine, her symptoms were gradually improved, and she was discharged home without relapse.
Tacrolimus is a rare cause of pancreatitis after kidney transplantation. It is important to note that tacrolimus-induced acute pancreatitis may occur during tacrolimus therapy in kidney transplantation patients.
药物性胰腺炎是急性胰腺炎的一种罕见病因。他克莫司已被用作器官移植患者的免疫抑制剂。然而，肾移植中他克莫司诱发急性胰腺炎的病例报告仅有少数几例。本病例报告的目的是提醒临床医生，肾移植患者在他克莫司治疗期间可能会发生他克莫司诱发的急性胰腺炎。
我们报告一例38岁女性患者，她接受了肾移植并接受他克莫司免疫抑制治疗；移植后第20天，她出现腹部中上部和左侧急性腹痛，伴有腹泻、恶心和呕吐。我们排除了胆结石病、酒精、高甘油三酯血症及其他可能病因，推测他克莫司是胰腺炎的可能病因，因为他克莫司血药浓度极高。将他克莫司换为环孢素后，她的症状逐渐改善，出院后未复发。
他克莫司是肾移植后胰腺炎的罕见病因。需要注意的是，肾移植患者在他克莫司治疗期间可能会发生他克莫司诱发的急性胰腺炎。
