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Acute relapsing pancreatitis induced with ursodeoxycholic acid therapy
A Nadir1, F Nadir, T Hassanein
1Oklahoma Transplantation Institute, Baptist Medical Center of Oklahoma, Oklahoma City 73112, USA.
Summary
Ursodeoxycholic acid may trigger acute relapsing pancreatitis in patients with Alagille syndrome and a long common channel. Discontinuation of the drug and liver transplant resolved pancreatitis attacks.
Area of Science:
- Gastroenterology and Hepatology
- Medical Case Reports
Background:
- Alagille syndrome is a genetic disorder affecting the liver, heart, and other organs.
- A long common channel between the biliary and pancreatic systems is a rare anatomical variation.
- Ursodeoxycholic acid is commonly used to treat liver conditions, including cholestasis.
Observation:
- A young adult woman with Alagille syndrome and a long common channel presented with recurrent acute pancreatitis.
- Pancreatitis attacks coincided with the initiation and continuation of ursodeoxycholic acid therapy for pruritus.
- Episodes of acute pancreatitis occurred monthly prior to intervention.
Findings:
- The patient experienced acute relapsing pancreatitis episodes exclusively during ursodeoxycholic acid treatment.
- Discontinuation of ursodeoxycholic acid therapy was associated with the cessation of pancreatitis attacks.
Implications:
- This case suggests a potential link between ursodeoxycholic acid and acute pancreatitis in susceptible individuals with specific anatomical and genetic predispositions.
- Management strategies for patients with Alagille syndrome and long common channel should consider potential drug-induced complications.
- Liver transplantation and cessation of ursodeoxycholic acid effectively resolved the recurrent pancreatitis, highlighting the importance of medication review and surgical intervention.