title: Acute necrotising pancreatitis derived from low-dose corticosteroid use: an important reminder of clinical management.
abstract: Although the exact mechanism is unknown, incidence of drug-induced pancreatitis from corticosteroids is well established in the medical literature. Commonly reported in chronic steroid-dependent individuals who require large doses for a wide array of pathologies, the incidence of damage to the pancreas from low-doses have not been well described. We report a case of a 68-year-old woman who presented with severe abdominal pain, nausea and vomiting, 3 days after the initiation of low-dose methylprednisolone for osteoarthritis. Inpatient laboratory analysis revealed an elevated lipase of 1770 U/L and CT scan showing extensive necrotising pancreatitis involving the head, body and tail. Cessation of the causative medication and conservative treatment successfully led to resolution of symptoms. We present this case to inform clinicians of the precipitance of pancreatitis from modest strength corticosteroid management, so that more accurate and improved performance in pharmacological decisions can be made for patient care.
authors.affiliation: Universidad Autonoma De Guadalajara, Guadalajara, Jalisco, Mexico.
authors.forename: Alexander
authors.initials: A
authors.lastname: Sabre
authors.affiliation: College of Health Sciences, Midwestern University, Glendale, Arizona, USA.
authors.forename: Morgan Mary
authors.initials: MM
authors.lastname: Guthrie
authors.affiliation: Scottsdale Healthcare System, Scottsdale, Arizona, USA.
authors.forename: Reza
authors.initials: R
authors.lastname: Maleknia
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000368:Aged; D019468:Disease Management; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008049:Lipase / Q000097:blood; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D010003:Osteoarthritis / Q000188:drug therapy*; D010179:Pancreas / Q000187:drug effects* / Q000473:pathology; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed
chemical_list: D000305:Adrenal Cortex Hormones; D005938:Glucocorticoids; D008049:Lipase; D008775:Methylprednisolone