Azathioprine or mercaptopurine-induced acute pancreatitis is not a disease-specific phenomenon.
BACKGROUND
Several reports suggest an increased rate of adverse reactions to azathioprine in patients with Crohn's disease.


OBJECTIVE
To compare the incidence of thiopurine-induced acute pancreatitis in patients with inflammatory bowel disease (IBD) with that in patients with vasculitis.


METHODS
This retrospective analysis was performed using data collected in three databases by two university hospitals (241 patients with IBD and 108 patients with vasculitis) and one general district hospital (72 patients with IBD).


RESULTS
The cumulative incidence of thiopurine-induced acute pancreatitis in Crohn's disease equalled that of ulcerative colitis (UC) (2.6% vs. 3.7%) and this did not differ from vasculitis patients (2.6% vs.1.9%). In addition, the cumulative incidence of thiopurine-induced acute pancreatitis in UC patients was not different from that in vasculitis patients. In the IBD group, 100% of thiopurine-induced acute pancreatitis patients were women, whereas in the vasculitis group the two observed thiopurine-induced acute pancreatitis cases (n = 2 of 2) concerned were men (P = 0.012).


CONCLUSIONS
In this study, the alleged higher cumulative incidence of thiopurine-induced acute pancreatitis in Crohn's disease compared with vasculitis or UC patients was not confirmed. Female gender appears to be a risk factor for developing thiopurine-induced acute pancreatitis in IBD patients.
van Geenen
E J M
EJ
Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam. ejm.vangeenen@vumc.nl
de Boer
N K H
NK
Stassen
P
P
Linskens
R K
RK
Bruno
M J
MJ
Mulder
C J J
CJ
Stegeman
C A
CA
van Bodegraven
A A
AA
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000963:Antimetabolites / Q000009:adverse effects*; D001379:Azathioprine / Q000009:adverse effects*; D003424:Crohn Disease / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D015122:Mercaptopurine / Q000009:adverse effects*; D008875:Middle Aged; D010195:Pancreatitis / Q000139:chemically induced*; D012189:Retrospective Studies; D013223:Statistics as Topic; D055815:Young Adult
D000963:Antimetabolites; D015122:Mercaptopurine; D001379:Azathioprine