Drug-Induced Acute Pancreatitis: Underdiagnosis and Overdiagnosis

Excerpt

As the incidence of acute pancreatitis continues to rise, establishing the etiology in order to prevent recurrence is important [1, 2]. Although the etiology of acute pancreatitis is not difficult in the majority of patients, almost a quarter of patients are initially labeled as having idiopathic acute pancreatitis [3]. When confronted with a patient with acute pancreatitis and no clear etiology defined as an absence of a history of alcoholism, absence of imaging demonstrating gallstones (ultrasound and/or MRI), and a normal triglyceride level, it is reasonable to consider a drug as the cause of acute pancreatitis. When considering a particular medication as causing acute pancreatitis, often the first step is a literature search. Data from pharmaceutical companies and/or the Food and Drug Administration (FDA) is not helpful. Typically, these sources cite many medications as causing acute pancreatitis despite the fact that the evidence provided does not have sufficient detail as to demonstrate causation. Published case reports, if detailed properly, can give more definitive information as to the diagnosis of acute pancreatitis and whether other causes besides drugs have been properly ruled out. …