PMID: 9184712Jun 1, 1997Paper

Pancreatic insufficiency due to antituberculous therapy

The Annals of Pharmacotherapy
B A LiuN H Shear

Abstract

To describe a case of chronic pancreatic insufficiency related to antituberculous therapy. A 57-year-old man developed rash, fever, and hepatitis (aspartate aminotransferase 369 IU/L, alanine aminotransferase 506 IU/L), 6 weeks after starting isoniazid, rifampin, ethambutol, and pyrazinamide. He also developed severe metabolic acidosis secondary to diabetic ketoacidosis and lactic acidosis (serum bicarbonate 7 mEq/L, glucose 1778 mg/dL, and lactate 4.0 mEq/L). Acute pancreatitis was diagnosed on the basis of a mildly elevated amylase concentration (392 U/L) and radiologic evidence of pancreatic inflammation. He developed pancreatic insufficiency with steatorrhea and an abnormal secretin test. He continues to require pancreatic enzyme replacement and insulin therapy. Rechallenge was not performed. Hypersensitivity syndromes have been reported for various drug therapies, including antituberculous agents. Hypersensitivity syndrome reactions are characterized by fever, rash, and internal organ involvement. Rifampin has been reported to cause acute pancreatitis in up to 2.7% of patients. Drug-induced chronic pancreatitis, however, is reported to be extremely rare. This is the first reported case of chronic pancreatic insufficiency o...Continue Reading

References

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Citations

Apr 20, 2012·Expert Review of Anti-infective Therapy·Rannakoe J Lehloenya, Keertan Dheda
Oct 3, 2007·Digestive Diseases and Sciences·M MarkovA Nadir
Aug 29, 2014·PLoS Neglected Tropical Diseases·Hong LiuFuren Zhang
Nov 28, 2001·Contact Dermatitis·S RebolloA Callejo

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