Pediatr Gastroenterol Hepatol Nutr.  2012 Dec;15(4):272-275.

Acute Pancreatitis Induced by Azathioprine and 6-mercaptopurine Proven by Single and Low Dose Challenge Testing in a Child with Crohn Disease

• Yi GC
• Yoon KH
• Hwang JB

Abstract

We report here a case of drug-induced acute pancreatitis proved by elimination and single, low dose challenge test in a child with Crohn disease. A 14-year-old boy with moderate/severe Crohn disease was admitted due to high fever and severe epigastric pain during administration of mesalazine and azathioprine. Blood test and abdominal ultrasonography revealed acute pancreatitis. After discontinuance of the medication and supportive care, the symptoms and laboratory findings improved. A single, low dose challenge test was done to confirm the relationship of the adverse drug reaction and acute pancreatitis, and to discriminate the responsible drug. Azathioprine and 6-mercaptopurine showed positive responses, and mesalazine showed a negative response. We introduce the method of single, low dose challenge test and its interpretation for drug-induced pancreatitis.

Keyword

Crohn disease; Inflammatory bowel diseases; Acute pancreatitis; Azathioprine; 6-mercaptopurine; Mesalamine; Child

MeSH Terms

6-Mercaptopurine
Azathioprine
Child
Crohn Disease
Drug Toxicity
Fever
Hematologic Tests
Humans
Inflammatory Bowel Diseases
Mesalamine
Pancreatitis
6-Mercaptopurine
Azathioprine
Mesalamine

Figure

• 

  Fig. 1 Change in amylase and lipase levels with drug administration, azathioprine, 6-mercaptopurine and mesalazine.

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