Lee Chiang Sheng, Tan Rachel Yi Ping, Rao Nitesh N
Renal Unit, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia, Australia.
College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Case Rep Nephrol. 2022 Aug 21;2022:9533266. doi: 10.1155/2022/9533266. eCollection 2022.
Gadolinium-induced acute pancreatitis is a rare phenomenon associated with the administration of gadolinium-based contrast agents. Only five cases of gadolinium-induced acute pancreatitis have been reported worldwide in patients with native pancreas and none with a pancreatic graft. We present a 32-year-old woman with prior history of simultaneous pancreas-kidney transplant who presented with generalized abdominal pain associated with systemic inflammatory response syndrome requiring admission to the intensive care unit. This occurred within 48 hours after having a magnetic resonance imaging (MRI) with gadolinium for investigation of subacute left optic atrophy. She was noted to have a marked rise in serum lipase, and the computed tomography findings were consistent with acute graft pancreatitis. Other causes of pancreatitis were ruled out, and she was managed conservatively with aggressive hydration, bowel rest, and analgesia with good recovery. This is the first reported case of gadolinium-induced acute graft pancreatitis occurring in a simultaneous pancreas-kidney transplant recipient. Clinicians should consider this rare differential diagnosis as a cause of graft pancreatitis in patients who have received gadolinium-based contrast agents.
钆诱导的急性胰腺炎是一种与使用钆基造影剂相关的罕见现象。全球范围内，仅报告了5例天然胰腺患者发生钆诱导的急性胰腺炎，而胰腺移植患者中尚无此类病例报告。我们报告一名32岁女性，有同时进行胰腺-肾脏移植的病史，因全身炎症反应综合征伴发的广泛性腹痛入院，需要入住重症监护病房。这发生在她接受含钆磁共振成像（MRI）以检查亚急性左视神经萎缩后的48小时内。她的血清脂肪酶显著升高，计算机断层扫描结果与急性移植胰腺胰腺炎相符。排除了胰腺炎的其他病因，她接受了积极补液、肠道休息和镇痛等保守治疗，恢复良好。这是首例报告的同时进行胰腺-肾脏移植受者发生钆诱导的急性移植胰腺胰腺炎的病例。临床医生应将这种罕见的鉴别诊断视为接受钆基造影剂的患者发生移植胰腺胰腺炎的一个病因。
