Hydroxyurea-Induced Acute Pancreatitis

Drug-induced pancreatitis (DIP), while not a major cause of acute pancreatitis, remains a debilitating diagnosis resulting in significant patient morbidity and mortality. The diagnosis includes first diagnosing acute pancreatitis, second ruling out more common etiologies (alcohol abuse, gallstones, etc.), and third documenting a thorough history (in particular medications). Essentially, it is a diagnosis of exclusion. Any drugs with the potential to result in acute pancreatitis should be discontinued, and those without future recurrence of pancreatitis are deemed to have had a drug-induced case. Although the exact pathophysiology of the initial development of DIP is unknown, we hypothesize it is different for various drug classes. It is known that once pancreatic enzymes are activated after insult, they activate an inflammatory response resulting in auto-digestion of the pancreas. Our report discusses a previously not documented case of DIP in a patient on hydroxyurea monotherapy for the treatment of Janus kinase 2 (JAK2) essential thrombocytosis.