Case Presentation of Acute Pancreatitis Related to Steroid Therapy

Acute pancreatitis (AP) is an acute clinical state which generally results from inflammation of the pancreas and typically presents with abdominal pain and high levels of pancreatic enzymes in the blood and urine. A twenty-five year -old woman admitted to emergency service with complaints of abdominal pain spreading back and unremitting, nausea and vomitting during the previous four days. Her medical history was unremarkable. It was learned that her abdominal pain began after she was treated with methylprednisolone 120 mg intravenously 15 days earlier. Her physical examination showed sensitivity and rebound in theepigastric region. Levels of amylase and lipase were 957 U/L (normal range 36-128) and 1193 U/L (normal range: 22-51), respectively. Abdominal computer tomography of the pancreas reported that the head region was wider than normal and heterogenous. The second part of the duodenum had diffuse wall thickening. Since no reason other than drug was found, steroid therapy was discontinued. Oral intake was stopped and fluid and electrolyte replacement were begun parenterally. The levels of amylase and lipase diminished to 99 U/L and 87 U/L (respectively) six day after discontinuation of steroid therapy. She was discharged from the gastroenterology unit on the ninth day of hospitalization. Whereas AP related to drug is rare, abdominal pain, nausea and vomiting during steroid therapy make the physician consider AP for the differential diagnosis.