PROBABLE PENTAMIDINE-INDUCED ACUTE-PANCREATITIS

OBJECTIVE: To report a case of probable pentamidine-induced acute panc reatitis. CASE SUMMARY: A patient was hospitalized because of fever, d yspnea, and productive cough. Chest X-ray revealed diffuse alveolar in filtrates, and the examination of bronchoalveolar lavage demonstrated the presence of Pneumocystis carinii. Intravenous co-trimoxazole was a dministered but the patient's condition did not improve. As secondary leukopenia appeared, the treatment was changed to pentamidine isethion ate 4 mg/kg/d iv. On day 5 of this new therapy, the patient experience d abdominal pain, and both blood and urine amylase concentrations rais ed to 330 U/L and 3960 U/L, respectively. The patient died 48 hours ta ter, and signs of acute pancreatitis were observed in necropsy. DISCUS SION: With reference to a classical method for estimating the probabil ity of adverse drug reactions, a probable relationship between pentami dine therapy and acute pancreatitis was found in this patient. Further more, no alternative causes of pancreatitis were present. CONCLUSIONS: It is likely that pentamidine administration in our patient resulted in an acute episode of pancreatitis. Serum and urine amylase concentra tions should be monitored in patients receiving this drug.