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conferenceseries
.com
Volume 8
Journal of Gastrointestinal & Digestive System
ISSN: 2161-069X
Bariatric Surgery 2018 & Gastro 2018
March 15-16, 2018
JOINT EVENT
12
th
Global Gastroenterologists Meeting
3
rd
International Conference on Metabolic and Bariatric Surgery
&
March 15-16, 2018 Barcelona, Spain
An unusual case of doxycycline-induced pancreatitis
Ashish Ahuja, Prerna Sharma and Bhagat Kondaveeti
University of Pittsburgh Medical Centre, USA
Introduction:
Acute pancreatitis is a disease with highmorbidity andmortality. Antibiotics like tetracyclines andmetronidazole
have been shown to be associated with this lethal condition. We report a case of a 47-year-old male presenting with acute
pancreatitis due to doxycycline use.
Case Description:
A 47-year-old male with a past medical history of hypertension and insulin-dependent diabetes presented
with a two-day history of abdominal pain, nausea and vomiting. Abdominal pain was in the epigastric region, radiating to the
back. It was associated with nausea and non-bilious, non-bloody emesis. Patient did not endorse fever with chills, diarrhoea
or other pertinent symptomatology. He was hemodynamically stable. Physical examination revealed tenderness and guarding
in the epigastric region. Laboratory investigations showed an elevated lipase level of 3853 and CRP (C-reactive protein) 6.40.
There was no leukocytosis, hypercalcemia, elevated transaminases or hyperbilirubinemia. Serum triglycerides were within
normal range. He was s/p cholecystectomy and RUQ ultrasound showed absent gallbladder, with no stricture or stone in the
bile ducts. CT abdomen and pelvis was refused by the patient. He denied alcohol, tobacco or illicit drug use. There was no
history of recent abdominal surgery or procedure. On further investigation, it was found that the patient had recently started
taking doxycycline for a foot ulcer. Symptoms started after 3 doses of doxycycline. He was not taking any other medications
which could potentially cause pancreatitis. Doxycycline was discontinued and patient was treated with fluid resuscitation with
good clinical response.
Discussion:
Drug-induced pancreatitis (DIP) comprises 1.4% of all cases of acute pancreatitis. 1. common culprits include
mesalazine, azathioprine, simvastatin and furosemide, but over 500 drugs have been implicated. 2. doxycycline been used
to treat common bacterial infections, including acne vulgaris and urinary tract infections. Although the pathophysiology is
not completely understood, it has been described as a rare cause of DIP. However, there are only four case reports following
doxycycline use and only two of those describe a case in which doxycycline was used as monotherapy, as in our case. 3. there
is a paucity of data on epidemiological variables related to doxycycline-induced pancreatitis. Further research is needed to
establish if there is a time or dose dependence to the phenomenon.
ahujaac@upmc.eduJ Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C1-065