Watanabe Yusuke, Akaike Eisei, Tokunaga Yuki, Murayama Kozue, Segawa Mari
Department of Cardiology, Japanese Red Cross Society Koga Hospital, Japan.
Department of Gastroenterology, Japanese Red Cross Society Koga Hospital, Japan.
J Rural Med. 2024 Jul;19(3):199-203. doi: 10.2185/jrm.2024-003. Epub 2024 Jul 1.
Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, COVID-19 vaccination has substantially reduced mortality and hospitalization rates worldwide, with rare adverse events reported in clinical settings. Herein, we present a case of acute pancreatitis complicated by diabetic ketoacidosis (DKA) following the third COVID-19 vaccination dose. A 72-year-old male with a history of diabetes mellitus developed generalized fatigue, mild epigastric pain, nausea, and frequent vomiting after receiving the COVID-19 vaccine. Blood analysis revealed elevated levels of pancreatic enzymes, hyperglycemia, and acidemia. Computed tomography revealed evidence of acute pancreatitis, leading to a diagnosis of both DKA and acute pancreatitis. Treatment with a large volume of saline and intravenous insulin improved both DKA and acute pancreatitis. After a thorough examination, no other factors capable of causing acute pancreatitis were identified. Hence, we concluded that acute pancreatitis was induced by COVID-19 vaccination. Acute pancreatitis is a rare but potentially life-threatening adverse event associated with COVID-19 vaccination. Delaying the treatment or diagnosis of acute pancreatitis can increase mortality risk in patients with both acute pancreatitis and DKA. Hence, it is crucial for healthcare professionals to consider the potential occurrence of acute pancreatitis and DKA following COVID-19 vaccination.
自2019年冠状病毒病（COVID-19）大流行开始以来，COVID-19疫苗接种已大幅降低了全球的死亡率和住院率，临床环境中报告的不良事件很少。在此，我们报告一例在接种第三剂COVID-19疫苗后并发糖尿病酮症酸中毒（DKA）的急性胰腺炎病例。一名有糖尿病病史的72岁男性在接种COVID-19疫苗后出现全身乏力、轻度上腹部疼痛、恶心和频繁呕吐。血液分析显示胰酶水平升高、高血糖和酸血症。计算机断层扫描显示有急性胰腺炎的迹象，从而诊断为DKA和急性胰腺炎。大量生理盐水和静脉注射胰岛素治疗改善了DKA和急性胰腺炎。经过全面检查，未发现其他能够引起急性胰腺炎的因素。因此，我们得出结论，急性胰腺炎是由COVID-19疫苗接种引起的。急性胰腺炎是一种与COVID-19疫苗接种相关的罕见但可能危及生命的不良事件。延迟急性胰腺炎的治疗或诊断会增加急性胰腺炎和DKA患者的死亡风险。因此，医护人员考虑COVID-19疫苗接种后急性胰腺炎和DKA的潜在发生情况至关重要。
