title: [Sodium diphenylhydantoin as a probable cause of pancreatitis].
abstract: BACKGROUND
  Drug-induced pancreatitis is much more common in children than in adults. Many drug have been implicated in its pathogenesis. Among the neuropsychiatric drugs only valproic acid, carbamazepine, clozapine and ergotamine have been reported. Phenytoin is commonly used for the treatment of epilepsy. It has been associated to pancreatitis only in two previous reports.
  
  
  METHODS
  Male adolescent who initiated with cerebellar hemorrhage due to an arteriovenous malformation. During his evolution he presented the following complications: pneumonia, two urinary tract infection, gastrointestinal bleeding and arterial hypertension. Eighteen days after admission he developed seizures and was treated with phenytoin. The next day he presented pancreatic symptoms and pancreatitis was confirmed by elevated enzymes and a CAT scan with pancreatic edema. Other etiologies were discarded. Pancreatic enzymes persisted high until phenytoin was stopped and have been within normal values after 18 months of follow-up.
  
  
  CONCLUSIONS
  In this case three of the four Miller criteria have been fulfilled. We consider that the antiepileptic treatment was the direct cause of the pancreatitis because there was a clear temporal association of the symptoms with the initiation and suspension of the drug.
authors.affiliation: Departamento de Gastroenterología, Hospital de Pediatría Centro Médico Nacional SXXI, Instituto Mexicano del Seguro Social, México, D.F.
authors.forename: A C
authors.initials: AC
authors.lastname: Sepúlveda Vildósola
authors.forename: E
authors.initials: E
authors.lastname: López Aguilar
authors.forename: P
authors.initials: P
authors.lastname: Yáñez López
authors.forename: R
authors.initials: R
authors.lastname: Ramírez Colorado
authors.forename: B
authors.initials: B
authors.lastname: Escobar Padilla
authors.forename: A
authors.initials: A
authors.lastname: Madrazo De la Garza
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects*; D002543:Cerebral Hemorrhage / Q000209:etiology; D004796:Clinical Enzyme Tests; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications; D008297:Male; D010195:Pancreatitis / Q000139:chemically induced* / Q000000981:diagnostic imaging; D010672:Phenytoin / Q000009:adverse effects*; D012640:Seizures / Q000188:drug therapy / Q000209:etiology; D014057:Tomography, X-Ray Computed
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin
vernacular_title: Difenilhidantoinato sódico como probable causa de pancreatitis.