ACUTE-PANCREATITIS DUE TO PYRITINOL - AN IMMUNE-MEDIATED PHENOMENON

A 23-year-old man experiencing three episodes of acute pancreatitis of undetermined etiology is described. Repeated questioning revealed tha t all three events had occurred after intake of the drug pyritinol. Co ntrolled rechallenge with a single dose of the drug led to a fourth ep isode of acute pancreatitis. Skin testing was negative, but lymphocyte stimulation tests and double fluorescence analysis detected pyritinol -activated CD4 and CD8 lymphocytes. Together with the clinical observa tion that the intervals between drug intake and start of symptoms of a cute pancreatitis became shorter with repeated exposure, the data are consistent with an immune-mediated origin of the pancreatitis. Pyritin ol has to be added to the list of drugs capable of inducing acute panc reatitis.