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急性胰腺炎:阿达木单抗在克罗恩病患者中引起的一种罕见副作用。

Acute Pancreatitis: An Unusual Side Effect of Adalimumab in Crohn's Disease Patient.

作者信息

El Ouardi Walid, Benazzouz Mustapha

机构信息

Resident in Gastroenterology, Faculty of Medicine and Pharmacy, Rabat, Morocco.

Department of Gastroenterology, International University of Rabat/Riad Annakhil International Polyclinic, Rabat, Morocco.

出版信息

Clin Med Insights Case Rep. 2025 Jan 22;18:11795476251315000. doi: 10.1177/11795476251315000. eCollection 2025.

Abstract

BACKGROUND

Drug-induced acute pancreatitis is a rare condition occurs at an incidence rate of 0.1-1.4% and represents a diagnostic challenge. TNFα inhibitors specially adalimumab is very rarely reported in the literature, primarily through case reports, as a potential cause of acute pancreatitis.

CASE PRESENTATION

Our case report presents a case of a 23-year-old patient followed for Crohn disease in whom a diagnosis of acute pancreatitis induced by adalimumab was made. This diagnosis was confirmed after the elimination of other possible etiologies, and notably by the recurrence of pancreatitis after Adalimumab rechallenge. The occurrence of acute pancreatitis induced by TNFα inhibitors exposes to the risk of pancreatitis with other drugs in this class, hence the need to switch to another therapeutic class, which was Ustekinumab in our case.

CONCLUSION

Acute pancreatitis is an unusual complication of treatment with Adalimumab. Through our experience, based on solid scientific data, we want to draw the attention of clinicians to the reality of this complication. It should be considered in any patient on TNFα inhibitors who presents with acute pancreatitis without an obvious cause.

摘要

背景

药物性急性胰腺炎是一种罕见疾病,发病率为0.1%-1.4%,是一个诊断难题。肿瘤坏死因子α(TNFα)抑制剂,尤其是阿达木单抗,在文献中很少被报道为急性胰腺炎的潜在病因,主要是通过病例报告。

病例介绍

我们的病例报告展示了一名23岁克罗恩病患者,诊断为阿达木单抗诱发的急性胰腺炎。在排除其他可能病因后,该诊断得以证实,特别是在再次使用阿达木单抗后胰腺炎复发。TNFα抑制剂诱发急性胰腺炎的发生提示使用该类其他药物也有发生胰腺炎的风险,因此有必要换用另一类治疗药物,我们的病例中换用的是乌司奴单抗。

结论

急性胰腺炎是阿达木单抗治疗的一种不常见并发症。基于我们的经验和可靠的科学数据,我们希望引起临床医生对这一并发症实际情况的关注。对于任何使用TNFα抑制剂且出现无明显病因的急性胰腺炎患者,均应考虑这一并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77f0/11755513/d075190c511e/10.1177_11795476251315000-fig1.jpg

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