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Acute pancreatitis following lisinopril rechallenge
1Emergency Care Services, Veterans Affairs Medical Center, Baltimore, MD 21201, USA.
The American Journal of Emergency Medicine
|September 3, 1998
Summary
Acute pancreatitis can be drug-induced. A case report details a severe reaction to lisinopril, an angiotensin-converting enzyme inhibitor, after a prior mild reaction.
Area of Science:
- Gastroenterology
- Pharmacology
Background:
- Acute pancreatitis is commonly caused by gallstones and alcohol.
- Drug-induced pancreatitis is a recognized but less common etiology.
- Angiotensin-converting enzyme (ACE) inhibitors are among the reported drug causes.
Observation:
- A patient developed acute pancreatitis within 3 hours of taking lisinopril.
- The patient had no other typical risk factors for pancreatitis.
- This was the second episode, with a milder reaction occurring 3 months prior.
Findings:
- This case highlights lisinopril as a potential cause of drug-induced pancreatitis.
- Rechallenge with lisinopril led to a more severe adverse reaction.
- The rapid onset suggests a hypersensitivity or idiosyncratic reaction.
Implications:
- Clinicians should consider ACE inhibitors like lisinopril in the differential diagnosis of acute pancreatitis.
- Patients with a history of pancreatitis after ACE inhibitors should be cautious about re-exposure.
- Further investigation into the mechanisms of ACE inhibitor-induced pancreatitis is warranted.