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他莫昔芬相关继发性高甘油三酯血症性胰腺炎1例及系统回顾
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Abstract:
本文报道了1例罕见的乳腺癌术后女性患者，术后长期口服他莫昔芬后发作急性胰腺炎。患者既往无胆胰疾病、饮酒史、高脂血症病史，排除自身免疫因素和遗传因素，其胰腺炎的发作与他莫昔芬使用后甘油三酯水平持续升高有关。他莫昔芬诱导的继发性高甘油三酯血症性急性胰腺炎非常罕见，到目前为止全世界仅有22例报道。此类患者使用他莫昔芬时间为12 (3~24)个月，发病时甘油三酯水平为1005 (365~2569) mg/dL，中重度急性胰腺炎的比例为68.1%，经积极治疗后预后较好。临床医生应警惕乳腺癌治疗药物他莫昔芬导致急性胰腺炎的罕见情况，使用药物过程中如出现甘油三酯明显升高应尽早加以干预。
We report a rare case of acute pancreatitis in a female patient with breast cancer after long-term oral tamoxifen. The patient had no previous history of biliary pancreatic disease, alcohol consumption, or hyperlipidemia. Excluding autoimmune and genetic factors, the onset of pancreatitis was related to the continuous increase of triglyceride level after tamoxifen. Secondary hypertriglyceridemia acute pancreatitis induced by tamoxifen is very rare, with only 22 cases reported worldwide to date. Tamoxifen was used for 12 (3~24) months, triglyceride level at onset was 1005 (365~2569) mg/dL, the proportion of moderate and severe acute pancreatitis was 68.1%, and the prognosis was good after active treatment. Clinicians should be alert to the rare occurrence of acute pancreatitis caused by the breast cancer treatment tamoxifen, and should intervene as soon as possible if a significant increase in triglycerides occurs during the use of the drug.
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