Hypertriglyceridemia-Associated Drug-Induced Acute Pancreatitis

Pancreas. 2019 Jan;48(1):22-35. doi: 10.1097/MPA.0000000000001190.

Abstract

Objectives: The aim of our study was to investigate the cases of drug-induced acute pancreatitis (DIAP) with hypertriglyceridemia as the mechanism of injury.

Methods: A MEDLINE search (1963-2018) of the English language literature was performed looking for all human case reports of adults (>18 years old) with hypertriglyceridemia as the mechanism of DIAP. The latest search date was February 28, 2018. Drugs were classified into probability groups based on a classification used by Badalov et al (Clin Gastroenterol Hepatol. 2007;5:648-661).

Results: The search revealed a total of 76 cases in 59 published reports. A total of 25 medications were found to be implicated in DIAP secondary to hypertriglyceridemia mechanism. Most of acute pancreatitis cases were mild or moderately severe with favorable outcomes. In 3 cases involving tamoxifen, pagaspargase, and quetiapine, patient death was the outcome. Plasmapheresis was only used in 9 cases in an effort to decrease triglyceride levels.

Conclusions: Hypertriglyceridemia-associated DIAP is a rare phenomenon, and the current systematic review provides a summary of drugs that have been implicated in this phenomenon, which allow physicians to be oriented about this adverse effect when these drugs are used.

Publication types

  • Systematic Review

MeSH terms

  • Acute Disease
  • Drug-Related Side Effects and Adverse Reactions / blood
  • Drug-Related Side Effects and Adverse Reactions / diagnosis*
  • Female
  • Humans
  • Hypertriglyceridemia / blood
  • Hypertriglyceridemia / complications*
  • Male
  • Pancreatitis / blood
  • Pancreatitis / complications*
  • Pancreatitis / pathology
  • Severity of Illness Index
  • Triglycerides / blood*

Substances

  • Triglycerides