title: Severe necrotizing pancreatitis following combined hepatitis A and B vaccination.
abstract: Necrotizing pancreatitis is a severe form of pancreatitis and is associated with substantial morbidity and mortality. We report a case of necrotizing pancreatitis that developed following combined hepatitis A and B vaccination. No other causes of pancreatitis could be determined. Although confirming the diagnosis is challenging, 3 main factors suggest a possible link to the vaccine: the chronology of the events, the patient's human leukocyte antigen genotype and the incongruent immune response to the vaccine components. This report serves to alert physicians to the possible development of necrotizing pancreatitis after vaccination.
authors.affiliation: General Surgery Residency Program, University of Toronto, Toronto, Ont. eran.shlomo@gmail.com
authors.forename: Eran
authors.initials: E
authors.lastname: Shlomovitz
authors.forename: Ward
authors.initials: W
authors.lastname: Davies
authors.forename: Ewa
authors.initials: E
authors.lastname: Cairns
authors.forename: William C
authors.initials: WC
authors.lastname: Brintnell
authors.forename: Mark
authors.initials: M
authors.lastname: Goldszmidt
authors.forename: George K
authors.initials: GK
authors.lastname: Dresser
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde; D003937:Diagnosis, Differential; D022362:Hepatitis A Vaccines / Q000009:adverse effects*; D017325:Hepatitis B Vaccines / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000139:chemically induced* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D017778:Vaccines, Combined / Q000009:adverse effects*
chemical_list: D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines; D017778:Vaccines, Combined