Keywords
Metformin
Pancreatitis, Acute necrotizing
How to Cite
Abstract
Acute Pancreatitis is an unusual side effect of Metformin. The case of a 29-year-old woman with a history of necrotizing Acute Pancreatitis, classified as Baltazar D in 2020, is presented. In March 2021, she experienced another episode of Acute Pancreatitis, this time classified as Baltazar C, without evident necrosis. Investigations did not reveal common causes, but it was noted that, in the two weeks preceding both episodes, the patient had received Metformin treatment for Polycys- tic Ovary syndrome and Prediabetes, respectively. The successful response involved intravenous fluid administration and discontinuation of the medication, preventing immediate complications, and achieving complete reversal of symptoms. In similar cases, it is crucial to identify risk factors, adjust the dose based on renal function, and closely monitor for any symptoms associated with acute pancreatitis.
References
Zheng J, Yang QJ, Dang FT, Yang J. Drug-induced pancreatitis: An update. Arab J Gastroenterol. 2019;20(4):183–188.
Garg SK, Sarvepalli S, Campbell JP, Obaitan I, Singh D, Bazerbachi F, et al. Incidence, admission rates, and predictors, and economic burden of adult emergency visits for acute pancreatitis: Data From the National Emergency Department Sample, 2006 to 2012 J Clin Gastroenterol. 2019;53(3):220-225.
Brindise E, Elkhatib I, Kuruvilla A, Silva R. Temporal trends in incidence and outcomes of acute pancreatitis in hospitalized patients in the United States from 2002 to 2013. Pancreas. 2019;48(2):169-175.
Wolfe D, Kanji S, Yazdi F, Skidmore B, Moher D, Hutton B. Methods for the early detection of drug-induced pancreatitis: A systematic review of the literature. BMJ Open. 2019;9(11):1–17.
Mederos MA, Reber HA, Girgis MD. Acute Pancreatitis: a review. JAMA. 2021;325(4):382– 390.
Rodríguez EM. Caracterización de los pacientes con pancreatitis aguda que ingresaron al Hospital Universitario Nacional entre abril de 2016 y septiembre de 2017. 2018. Universidad Nacional de Colombia Sede Bogotá Facultad de Medicina Departamento de Medicina Interna.
Balthazar E, Robinson D, Megibow A. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174(2): 331-336.
Wolfe D, Kanji S, Yazdi F, Barbeau P, Rice D, Beck A, et al. Drug induced pancreatitis: A systematic review of case reports to determine potential drug associations.PLoS One. 2020;15(4):e0231883.
Puerto L, Medina R, Nuñez L, JimeÃÅnez H, Olaya J, SanjuaÃÅn J, et al. Outcomes of Three Years of Experience Managing Acute Pancreatitis at a Fourth Level Hospital in Huila, Colombia. Rev Colomb Gastroenterol. 2019;34(1):10-16.
Fimognari FL, Corsonello A, Pastorell R, Antonelli- Incalzi R. Metformin-induced pancreatitis. Diabetes Care. 2006;29(5):1183.
Mallick S. Metformin induced acute pancreatitis precipitated by renal failure. Postgrad Med J. 2004;80(942):239-240.
Audia P, Feinfeld DA, Dubrow A, Winchester JF. Metformin-induced lactic acidosis and acute pancreatitis precipitated by diuretic, celecoxib, and candesartan-associated acute kidney dysfunction. Clin Toxicol. 2008;46(2):164-166.
Ben MH, Thabet H, Zaghdoudi I, Amamou M. Metformin associated acute pancreatitis. Vet Hum Toxicol. 2002;44(1):47-48.
Echouffo J, Perreault L, Ji L, Dagogo S. Diagnosis and Management of Prediabetes: A Review. JAMA. 2023;329(14), 1206-1216.
American Diabetes Association Professional Practice Committee; 3. Prevention or Delay of Diabetes and Associated Comorbidities: Standards of Care in Diabetes-2024. Diabetes Care 2024; 47(Supplement_1):S43-S51. https:// doi.org/10.2337/dc24-S003
World Health Organization (WHO)-Uppsala Monitoring Centre. The use of the WHO- UMC system for standardized case causality assessment. Available from: http://www.who- umc.org/Graphics/24734.pdf
Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239-245.
Suchard JR, Grotsky TA. Fatal metformin overdose presenting with progressive hyperglycemia. West J Emerg Med. 2008;9(3):160-164.
Gioia S, Lancia M, Persichini A, Tondi V, Bacci M, Suadoni F. Pancreatitis and Metformin: Case- Report and Review of Literature. J Hepatol Gastrointest Disord. 2016;2(4).
Damughatla AR, Surapaneni S, Wadehra A, Kabashneh S, Shanah L. A Novel Case of Metformin-Induced Pancreatitis in an Individual With Normal Dosing and No Underlying Chronic Kidney Disease. Cureus. 2022;14(5):e25116.
Alsubaie S, Almalki MH. Metformin induced acute pancreatitis. Dermatoendocrinol. 2013;5(2):317- 318.
Molina Infante J, Prieto Bermejo AB, Pérez Gallardo B, Fernández Bermejo M. Pancreatitis aguda tóxica por metformina sin insuficiencia renal . Med Clin. 2008;131(13):519.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2024 Médicas UIS