title: Tamoxifen precipitation of familial hypertriglyceridaemia: a rare cause of acute pancreatitis.
abstract: Drug-induced pancreatitis is uncommon, and is estimated to account for between 0.1% and 5% of cases. Tamoxifen is commonly used in the management of oestrogen receptor-positive breast cancer. We present a rare case of tamoxifen-related hyperlipidaemia resulting in repeated episodes of pancreatitis, which, to the best of our knowledge, has only been documented a few times in the literature. A 36-year-old woman with familial hypertriglyceridaemia presented with recurrent episodes of abdominal pain, modest increases in serum amylase levels and normal liver function tests. The patient had recently been diagnosed with breast carcinoma and was managed with wide local excision (WLE), adjuvant radiotherapy and tamoxifen. On each admission, the patient's symptoms were confirmed either biochemically and/or radiologically. Analysis of the case led to a diagnosis of precipitation of familial hypertriglyceridaemia from tamoxifen use resulting in pancreatitis. Management was altered with tamoxifen cessation and initiation of second-line hormonal therapy. Tamoxifen use needs consideration, especially in those with familial hyperlipidaemia.
authors.affiliation: Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, Birmingham, UK.
authors.forename: Ali
authors.initials: A
authors.lastname: Wadood
authors.affiliation: Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, Birmingham, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Chesner
authors.affiliation: Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, Birmingham, UK.
authors.forename: Mehboob
authors.initials: M
authors.lastname: Mirza
authors.affiliation: Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, Birmingham, UK.
authors.forename: Shafquat
authors.initials: S
authors.lastname: Zaman
mesh_terms: D015746:Abdominal Pain / Q000139:chemically induced; D000208:Acute Disease; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006953:Hyperlipoproteinemia Type IV / Q000139:chemically induced* / Q000150:complications; D010195:Pancreatitis / Q000139:chemically induced*; D013629:Tamoxifen / Q000009:adverse effects*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen