Dramatic improvement with clonidine in acute pancreatitis with elevated catecholamine and cortisol plasma levels: report of five cases.
We report five cases of patients with acute pancreatitis (AP) resistant to conventional treatment who improved dramatically with clonidine. All patients showed greatly elevated plasma levels of noradrenaline (norepinephrine) (NA), adrenalin (epinephrine) (Ad) and cortisol (CRT), physiologic indicators of stress, which decreased abruptly upon initiation of clonidine therapy. The clonidine test performed in the patients showed a hyper-response in all, a reaction consistent with uncoping stress situations. Therefore, we postulate that stress might play a role in the pathogenesis of pancreatic inflammatory disease in these patients.
Lechin
F
F
Section of Gastroenterology, Institute of Experimental Medicine, School of Medicine, Central University of Venezuela.
van der Dijs
B
B
Lechin
M
M
Jara
H
H
Lechin
A
A
Cabrera
A
A
Rada
I
I
Orozco
B
B
Jiménez
V
V
Valderrama
T
T
D000208:Acute Disease; D000328:Adult; D002395:Catecholamines / Q000097:blood; D003000:Clonidine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D010195:Pancreatitis / Q000097:blood / Q000188:drug therapy*
D002395:Catecholamines; D003000:Clonidine; D006854:Hydrocortisone