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Probable pentamidine-induced acute pancreatitis
J Sauleda1, J G Gea, M C Aguar
1Servei de Pneumologia, Hospital del Mar, Universitat Autònoma de Barcelona, Catalonia, Spain.
The Annals of Pharmacotherapy
|January 1, 1994
Summary
Pentamidine may cause acute pancreatitis in patients treated for Pneumocystis pneumonia. Monitoring amylase levels during pentamidine therapy is recommended to detect this serious adverse drug reaction.
Area of Science:
- Medical Case Study
- Pharmacology
- Gastroenterology
Background:
- Pneumocystis pneumonia (PCP) is a serious infection often treated with antimicrobial agents.
- Pentamidine isethionate is an alternative treatment for PCP, particularly when cotrimoxazole fails or is contraindicated.
- Adverse drug reactions to pentamidine can occur, necessitating careful patient monitoring.
Observation:
- A patient with PCP initially treated with cotrimoxazole showed no improvement and developed leukopenia.
- Treatment was switched to intravenous pentamidine isethionate.
- On day 5 of pentamidine therapy, the patient developed abdominal pain and elevated serum and urine amylase levels, indicative of acute pancreatitis.
Findings:
- A case study suggests a probable link between pentamidine administration and the development of acute pancreatitis.
- Laboratory findings (elevated amylase) and necropsy results supported the diagnosis of acute pancreatitis.
- No alternative causes for the pancreatitis were identified in this patient.
Implications:
- Pentamidine therapy may be associated with a risk of acute pancreatitis.
- Close monitoring of serum and urine amylase levels is crucial for patients receiving pentamidine.
- This case highlights the importance of recognizing and managing potential drug-induced pancreatitis.