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Pancreatitis due to codeine.

M C Moreno Escobosa1, J Amat López, S Cruz Granados

  • 1Sección de Alergia, Hospital Torrecárdenas, Almería, Spain. moreno.escobosa@terra.es

Allergologia Et Immunopathologia
|June 11, 2005
PubMed
Summary
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Codeine, a common pain reliever, can rarely cause pancreatitis. This case highlights a potential link between codeine and pancreatitis, possibly due to sphincter of Oddi dysfunction.

Area of Science:

  • Pharmacology
  • Gastroenterology
  • Clinical Medicine

Background:

  • Pancreatitis is a rare but serious adverse effect.
  • Codeine is an opioid analgesic commonly used for pain relief.
  • Sphincter of Oddi dysfunction (SOD) can lead to biliary and pancreatic issues.

Observation:

  • A 42-year-old man developed epigastric pain, rash, and facial angioedema after taking acetaminophen with codeine.
  • Laboratory tests revealed elevated liver enzymes and serum amylase.
  • Imaging ruled out gallstones but noted a prior cholecystectomy.

Findings:

  • The patient's symptoms and laboratory results were consistent with pancreatitis.
  • Allergy testing for codeine was negative, suggesting a non-immunological adverse reaction.

Related Experiment Videos

  • The proposed mechanism involves codeine-induced spasm of the sphincter of Oddi, exacerbated by pre-existing dysfunction.

    • Implications:

    • This case suggests a potential non-immunological adverse effect of codeine leading to pancreatitis.
    • Clinicians should consider codeine-induced pancreatitis in patients with risk factors like prior cholecystectomy.
    • Further investigation into the non-immunological mechanisms of codeine-induced pancreatitis is warranted.