Tofacitinib-Induced Acute Pancreatitis in a Patient with Rheumatoid Arthritis: A Case Report and Review of the Literature.

IF 1.1 Q4 PHARMACOLOGY & PHARMACY
Hiba Boussaa, Ons Hamdi, Saoussen Miladi, Yasmine Makhlouf, Kawther Ben Abdelghani, Alia Fazaa, Ahmed Laatar
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Abstract

Background: Acute Pancreatitis (AP) is an uncommon complication that rarely occurs during Rheumatoid Arthritis (RA). Among the varied etiologies of AP, Drug-induced Pancreatitis (DIP) remains a rare entity and a rather challenging condition. A large panel of drugs have been reported to cause pancreatitis; however, there are no cases of tofacitinib-induced pancreatitis reported in the literature.

Case presentation: We have, herein, reported the case of a Tunisian 58-year-old woman with a four-year history of RA who experienced two episodes of AP; the first one occurred on the second day of a 3-day series of methylprednisolone intravenous injections, and the second episode occurred on the sixth-day of tofacitinib administration. Each time, she presented acute abdominal pain with characteristic radiation to the back. Symptoms resolved spontaneously once the suspected drug was discontinued. In the event of a negative investigation, including abdominal ultrasonography and magnetic resonance imaging, and assessment of albumin, calcemia, triglyceridemia, serum ferritin, and IgG4 levels, DIP was the most likely diagnosis.

Conclusion: Although DIP is still a rare condition, it remains serious with an increased risk of mortality. We intended to alert clinicians that in addition to the known side effects of tofacitinib, pancreatitis may be induced by this drug, especially in predisposed patients.

类风湿性关节炎患者的托法替尼诱发急性胰腺炎:病例报告和文献综述。
背景:急性胰腺炎(AP)是一种不常见的并发症,在类风湿关节炎(RA)期间很少发生。在急性胰腺炎的各种病因中,药物诱发的胰腺炎(DIP)仍然是一种罕见的病因,也是一种颇具挑战性的病症。据报道,有大量药物可引起胰腺炎;然而,文献中还没有报道过托法替尼诱发胰腺炎的病例:我们在此报告了一例 58 岁的突尼斯妇女的病例,她有四年的 RA 病史,曾经历过两次 AP 发作;第一次发生在甲基强的松龙静脉注射 3 天系列治疗的第二天,第二次发生在服用托法替尼的第六天。她每次都表现为急性腹痛,并有向背部放射的特征。停用可疑药物后,症状自行缓解。如果包括腹部超声波检查和磁共振成像在内的检查结果呈阴性,并评估了白蛋白、血钙、甘油三酯血症、血清铁蛋白和 IgG4 水平,DIP 是最有可能的诊断:结论:尽管 DIP 仍是一种罕见病,但其严重性和死亡风险仍在增加。我们希望提醒临床医生,除了已知的托法替尼副作用外,该药物还可能诱发胰腺炎,尤其是易感患者。
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来源期刊
Current drug safety
Current drug safety PHARMACOLOGY & PHARMACY-
CiteScore
2.10
自引率
0.00%
发文量
112
期刊介绍: Current Drug Safety publishes frontier articles on all the latest advances on drug safety. The journal aims to publish the highest quality research articles, reviews and case reports in the field. Topics covered include: adverse effects of individual drugs and drug classes, management of adverse effects, pharmacovigilance and pharmacoepidemiology of new and existing drugs, post-marketing surveillance. The journal is essential reading for all researchers and clinicians involved in drug safety.
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