World Journal of
Pharmaceutical and Life Sciences

ACUTE DRUG-INDUCED PANCREATITIS SECONDARY TO AZATHIOPRINE: A CASE REPORT AT THE PEDIATRIC DEPARTMENT OF RABAT MILITARY HOSPITAL

Sara Al Maimouni*, Ismail Belhaouz, Brahim El Hasbaoui, Liban Mehdi Mohamed, Nouha Al Maimouni

ABSTRACT

Azathioprine (Imurel) is commonly used in the treatment of autoimmune diseases, including autoimmune hepatitis. Although generally well tolerated, azathioprine can occasionally induce serious adverse effects, such as acute pancreatitis. We report the case of a 12-year-old girl with autoimmune hepatitis treated with azathioprine 2 mg/kg/day and corticosteroids 2 mg/kg/day. Two weeks after the introduction of azathioprine, the patient was admitted to hospital with severe abdominal pain and apyrexia. Clinical examination revealed epigastric tenderness with no other significant abnormalities. Biological investigations revealed hyperlipaemia at 295 IU/L, elevated liver enzymes and cytopenia. Abdominal ultrasound and computed tomography (CT) confirmed the diagnosis of acute pancreatitis (stage IB) associated with portal hypertension and splenomegaly with ascites. Treatment consisted of azathioprine discontinuation, digestive rest and analgesic therapy. The clinical course was favorable, with disappearance of abdominal pain and normalization of lipasemia. This case illustrates the importance of closely monitoring patients on azathioprine for signs of acute pancreatitis, and of acting promptly in case of suspicion.

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