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Acute pancreatitis in a prisoner with AIDS. Bugs or drugs?
1Charleston County Medical Examiner's Office, Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston 29425.
Abstract:
Acute pancreatitis has been the cause of death in several patients with AIDS and AIDS-related complex (ARC). Documented etiologies include several microorganisms and adverse drug reactions. We present a case of an HIV-positive prison inmate who died of acute necrotizing pancreatitis. Although he was infected with Mycobacterium avium-intracellulare, it is more likely that 2',3'-dideoxyinosine, an antiretroviral agent, induced pancreatitis. It is important to obtain a thorough pharmaceutical history in HIV-positive patients. Fatal medicinal reactions may result in death in ARC or AIDS patients. Documentation of opportunistic infection in AIDS patients may prove difficult and expensive, but costs may be minimized and diagnostic accuracy optimized if appropriate tissue samples, including lymph nodes, are submitted for histologic analysis.
Insights
Acute pancreatitis can be fatal in patients with HIV/AIDS. A case suggests the antiretroviral drug 2',3'-dideoxyinosine may induce fatal pancreatitis, highlighting the need for pharmaceutical history in HIV care.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Pharmacology
Background:
- Acute pancreatitis is a severe complication observed in patients with Acquired Immunodeficiency Syndrome (AIDS) and AIDS-Related Complex (ARC).
- Etiologies for pancreatitis in this population include opportunistic infections and adverse drug reactions.
Observation:
- A case study of an HIV-positive prison inmate who developed fatal acute necrotizing pancreatitis is presented.
- The patient was infected with Mycobacterium avium-intracellulare, but the pancreatitis was more likely induced by 2",3"-dideoxyinosine, an antiretroviral medication.
Findings:
- The study highlights a potential link between 2',3'-dideoxyinosine (ddI) and acute necrotizing pancreatitis in HIV-positive individuals.
- Fatal adverse drug reactions can occur in patients with ARC or AIDS, emphasizing the critical role of comprehensive pharmaceutical histories.
Implications:
- Accurate diagnosis of opportunistic infections in AIDS patients can be challenging and costly.
- Submitting appropriate tissue samples, such as lymph nodes, for histologic analysis can optimize diagnostic accuracy and potentially minimize costs.