[Acute necrotic pancreatitis secondary to asparaginase. Role of drug combinations--early diagnosis and treatment. Apropos of 2 cases].
Acute necrotic pancreatitis was diagnosed in two patients treated with asparaginase for, in the first case a highly malignant lymphoma and in the second an acute lymphoblastic leukemia. The diagnosis on clinical findings and amylase assay results was confirmed by LDH and/or C reactive protein values and abdominal CT scans. Both patients recovered after drainage of peripancreatic fluid collections, in the first patient by surgical followed by cutaneous drainage and in the second by cutaneous drainage of a pancreatic pseudocyst. In addition to the frequent pancreatic reaction observed during asparaginase treatment, signs of pancreatic necrosis requiring urgent treatment have to be identified. The necrotic nature of the pancreatitis was confirmed by clinical examination, assay to biologic markers and abdominal CT scans, eliminating other causes of the pancreatitis.
Service de Chirurgie Adultes Ouest, Hôpital Cl. Huriez, C.H.R.U., Lille.
J P
JP
Chambon
B
B
Dupriez
P
P
Danjou
M
M
Provost
F
F
Bauters
A
A
Wurtz
P
P
Quandalle
D000208:Acute Disease; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001215:Asparaginase / Q000009:adverse effects* / Q000627:therapeutic use; D004322:Drainage; D005260:Female; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000188:drug therapy; D016400:Lymphoma, Large-Cell, Immunoblastic / Q000188:drug therapy; D008297:Male; D009336:Necrosis; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010195:Pancreatitis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed
D001215:Asparaginase
Pancréatite aiguë nécrotique secondaire à l'asparaginase. Rôle des associations médicamenteuses--diagnostic précoce et traitement. A propos de 2 observations.