title: Recurrent pancreatitis after trimethoprim-sulfamethoxazole rechallenge.
abstract: We report a female patient who repeatedly developed pancreatitis after trimethoprim-sulfamethoxazole (TMP/SMX) use. During childhood she had undergone an ureterosigmoidostomy after which she had been on TMP/SMX 480 mg daily as prophylaxis for pyelonephritis for many years. The patient presented with abdominal pain caused by acute pancreatitis. No other cause, except for TMP/SMX use, could be identified. A causal relationship was confirmed by relapse of the pancreatitis after rechallenge. Our case is unique in demonstrating that acute pancreatitis related to the use of TMP/SMX may occur even after long-term treatment. We advise that the medication is discontinued immediately if a causal relationship with pancreatitis is suspected.
authors.affiliation: Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.
authors.forename: M W J
authors.initials: MW
authors.lastname: Versleijen
authors.forename: A H J
authors.initials: AH
authors.lastname: Naber
authors.forename: N P
authors.initials: NP
authors.lastname: Riksen
authors.forename: G J
authors.initials: GJ
authors.lastname: Wanten
authors.forename: F M J
authors.initials: FM
authors.lastname: Debruyne
mesh_terms: D000892:Anti-Infective Agents, Urinary / Q000009:adverse effects* / Q000627:therapeutic use; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000139:chemically induced* / Q000175:diagnosis; D011704:Pyelonephritis / Q000517:prevention & control; D012008:Recurrence; D013997:Time Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000892:Anti-Infective Agents, Urinary; D015662:Trimethoprim, Sulfamethoxazole Drug Combination