Angiotensin-converting-enzyme inhibitor administration must be monitored for serum amylase and lipase in order to prevent an acute pancreatitis - A case report

Some clinical cases published in literature show that angiotensin-convertin g enzyme (ACE)-inhibitor administration may cause acute pancreatitis. In th is work, the authors report a case of a patient affected by hypertension. U pon admission, the authors started antihypertensive therapy using captopril , which caused an important amylase and lipase rise within 13 days. When th e ACE-inhibitor therapy was stopped, a rapid decrease of the serum enzyme w as observed within 3 days, The high levels of serum amylase and lipase were linked to neutrophilia but were not associated with relevant symptomatic f indings or features of pancreatopathy. The absence of the usual conditions that may cause pancreatitis, such as biliary stasis, hypercalcemia, or alco hol abuse, and the rapid decrease of serum enzyme levels after drug suspens ion suggested an ACE-inhibitor-induced pancreatitis. This is the first clin ical report of an ACE-inhibitor-induced pancreatitis in which captopril adm inistration was found after hospitalization. The drug suspension probably p revented other complications. This case report suggests that, when ACE-inhi bitor administration is started, serum amylase and lipase should be monitor ed in order to prevent acute pancreatitis without waiting for clinical evid ence of a pancreatopathy.