title: Continuous regional arterial infusion effective for children with acute necrotizing pancreatitis even under neutropenia.
abstract: Severe acute pancreatitis is one of the critical conditions that may develop in children with cancer. The leading cause of death due to acute pancreatitis is infectious pancreatitis or circulation collapse. Therefore, patients who develop acute pancreatitis while undergoing chemotherapy or after hematopoietic transplantation are at risk for a life-threatening and fatal course. We treated 140 patients with malignancy from April 2002 to March 2009 at our hospital and encountered 3 patients under neutropenia who developed severe acute pancreatitis. Two of them were successfully treated with continuous regional arterial infusion of a protease inhibitor and antibiotic even under agranulocytosis. Another patient was treated with conventional therapy with intravenous antibiotics plus a protease inhibitor and total or partial parenteral nutrition. Even though the two patients treated with continuous regional arterial infusion presented much more severe conditions, their symptoms resolved earlier. In conclusion, acute pancreatitis is one of the severe complications of childhood malignancy. Even under agranulocytosis, continuous regional arterial infusion of a protease inhibitor and antibiotic was well tolerated and effective among our cases and might reduce early death due to pancreatitis.
authors.affiliation: Department of Pediatrics, University of Tsukuba Hospital, University of Tsukuba, Tsukuba, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Fukushima
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukushima
authors.forename: Ryoko
authors.initials: R
authors.lastname: Suzuki
authors.forename: Takashi
authors.initials: T
authors.lastname: Enokizono
authors.forename: Maki
authors.initials: M
authors.lastname: Matsunaga
authors.forename: Tomohei
authors.initials: T
authors.lastname: Nakao
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Koike
authors.forename: Kensaku
authors.initials: K
authors.lastname: Mori
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Matsueda
authors.forename: Ryo
authors.initials: R
authors.lastname: Sumazaki
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D009503:Neutropenia / Q000188:drug therapy / Q000209:etiology*; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000188:drug therapy*; D011480:Protease Inhibitors / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D011480:Protease Inhibitors