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Ever-increasing diversity of drug-induced pancreatitis

World Journal of Gastroenterology 2020年第22期26卷 2902-2915页

作者： Simcha Weissman Muhammad Aziz Ryan B Perumpail Tej I Mehta Rutwik Patel James H Tabibian Department of Medicine Hackensack University-Palisades Medical CenterNorth BergenNJ 07047United States Department of Medicine University of Toledo Medical CenterToledoOH 43614United States Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at UCLALos AngelesCA 90095United States Department of Interventional Radiology Johns Hopkins University HospitalBaltimoreMD 21205United States Division of Gastroenterology Department of MedicineOlive View-UCLA Medical CenterSylmarCA 91342 and David Geffen School of Medicine at UCLALos AngelesCA 90095United States

With over 100000 hospital admissions per annum,acute pancreatitis remains the leading gastrointestinal cause of hospitalization in the United States and has farreaching impact well *** has become increasingly recognized that druginduced pancreatitis(DIP),despite accounting for less than 3%of all cases,represents an important and growing though often inconspicuous cause of acute ***,knowledge of DIP is often curtailed by the limited availability of evidence needed to implicate given agents,especially for nonprescription ***,the majority of available data is derived from case reports,case series,or case control ***,the mechanism of injury and causality for many of these drugs remain elusive as a definitive correlation is generally not established(<10%of cases).Several classification systems have been proposed,but no single system has been widely adopted,and periodic updates are required in light of ongoing pharmacologic ***,infrequently prescribed medications or those available over-thecounter(including herbal and other alternative remedies)are often overlooked as a potential culprit of acute ***,we review the ever-increasing diversity of DIP and the potential mechanisms of injury with the goal of raising awareness regarding the nature and magnitude of this *** believe this manuscript will aid in increasing both primary and secondary prevention of DIP,thus ultimately facilitating more expedient diagnosis and a decrease in DIPrelated morbidity.

关键词： drug-induced pancreatitis Acute pancreatitis Pharmacology Mechanism of action Inflammation Etiology

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induced pluripotent stem cells as an innovative model to study drug induced pancreatitis

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World Journal of Gastroenterology 2021年第35期27卷 5796-5802页

作者： Elena Genova Gabriele Stocco Giuliana Decorti Institute for Maternal and Child Health IRCCS Burlo GarofoloTrieste 34137Italy Department of Life Sciences University of TriesteTrieste 34127Italy Department of Medical Surgical and Health SciencesUniversity of TriesteTrieste 34127Italy

drug-induced pancreatitis is a gastrointestinal adverse effect concerning about 2%of *** majority of cases are mild to moderate but severe episodes can also occur,leading to hospitalization or even ***,the mechanisms of this adverse reaction are still not clear,hindering its prevention,and the majority of data available of this potentially life-threatening adverse effect are limited to case reports leading to a probable underestimation of this *** particular,in this editorial,special attention is given to thiopurine-induced pancreatitis(TIP),an idiosyncratic adverse reaction affecting around 5%of inflammatory bowel disease(IBD)patients taking thiopurines as immunosuppressants,with a higher incidence in the pediatric *** biomarkers are not available to assist clinicians in the prevention of TIP,also because of the inaccessibility of the pancreatic tissue,which limits the possibility to perform dedicated cellular and molecular *** this regard,induced pluripotent stem cells(iPSCs)and the exocrine pancreatic differentiated counterpart could be a great tool to investigate the cellular and molecular mechanisms underlying the development of this undesirable *** particular type of stem cells is obtained by reprogramming adult cells,including fibroblasts and leukocytes,with a set of transcription factors known as the Yamanaka’s *** unaltered the donors’genetic heritage,iPSCs represent an innovative model to study the mechanisms of adverse drug reactions in individual patients’tissues not easily obtainable from human ***,iPSCs can differentiate under adequate stimuli into almost any somatic lineage,opening a new world of opportunities for *** works are already available in the literature studying liver,central nervous system and cardiac cells derived from iPSCs and adverse drug ***,to our knowledge no studies have been performed on exocrine pancreas differentiated

关键词： induced pluripotent stem cells Therapy personalization Patient-specific cells drug-induced pancreatitis Thiopurines Inflammatory bowel disease

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Pravastatin:A potential cause for acute pancreatitis

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World Journal of Gastroenterology 2006年第43期12卷 7055-7057页

作者： Constantine Tsigrelis CS Pitchumoni Department of Internal Medicine Sain Peter's University Hospital Robert Wood Johnson Medica School New Brunswick NJ United States Division of Gastroenterology Hepatology and Clinical Nutrition Department of Internal Medicine Saint Peter's University Hospital Robert Wood Johnson Medical School New Brunswick NJ United States

Acute pancreatitis （AP） secondary to drugs is uncommon, with an incidence ranging from 0.3% to 2.0% of AP cases. drug-induced AP due to statins is rare, and only 12 cases have thus far been reported. In this case report, we report a case of a 50-year-old female on pravastatin therapy for 3 d prior to developing symptoms of AP. The common etiological factors for AP were all excluded. The patient was admitted to the intensive care unit secondary to respiratory distress, though she subsequently improved and was discharged 14 d after admission. Although the incidence of drug-induced AP is low, clinicians should have a high index of suspicion for it in patients with AP due to an unknown etiology. Clinicians should be aware of the association of statins with AR If a patient taking a statin develops abdominal pain, clinicians should consider the diagnosis of AP and conduct the appropriate laboratory and diagnostic evaluation if indicated.

关键词： drug-induced pancreatitis Acute pancreatitis Statins Pravastatin.

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Acute pancreatitis associated with intravenous administration of propofol:evaluation of causality in a systematic review of the literature

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Gastroenterology Report 2019年第1期7卷 13-23,I0001页

作者： Samir Haffar Ravinder Jeet Kaur Sushil Kumar Garg Joseph A.Hyder M.Hassan Murad Barham K.Abu Dayyeh Fateh Bazerbachi Digestive Center for Diagnosis&Treatment 29 Ayar StreetDamascusSyrian Arab Republic Division of Gastroenterology and Hepatology Mayo Clinic200 First Street SWRochesterMN 55905USA Division of Anesthesiology and Perioperative Medicine Mayo Clinic200 First Street SWRochesterMN 55905USA Division of Health Care Policy and Research Mayo Clinic200 First Street SWRochesterMN 55905USA

Acute pancreatitis(AP)associated with intravenous administration of propofol has been described with unknown causal *** therefore assessed this causality in a systematic *** databases were searched on 16 August 2017;studies were appraised and selected by two reviewers based on a priori *** causality was evaluated with the Naranjo scale and Badalov *** identified 18 studies from 11 countries with a total of 21 patients,and the majority had adequate methodological *** median age was 35 years(range,4–77)and 10(48%)were ***,propofol was administrated in 8 patients as sedative along with induction/maintenance of anesthesia in 13 patients;median dose was 200 mg,with intermediate latency(1–30 days)in 14(67%).Serum triglycerides were>1000 mg/dL in four *** AP was observed in four patients(19%).AP recurrence occurred in one out of two patients who underwent *** related to AP was 3/21(14%).Propofol was the probable cause of AP according to the Naranjo scale in 19 patients(89%).Propofol-induced AP has a probable causal relation and evidence supports Badalov class *** is not the only mechanism by which propofol illicit ***-induced AP was severe in 19%of patients with a mortality rate related to AP of 14%.Future research is needed to delineate whether this risk is higher if combined with other procedures that portend inherent risk of pancreatitis such as endoscopic retrograde cholangiopancreatography.

关键词： Acute pancreatitis drug-induced pancreatitis propofol systematic review

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