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Acute pancreatitis: case report A 16-year-old girl developed acute pancreatitis during treatment with asparaginase and prednisolone for acute lymphoblastic leukaemia type 1 phenotype-B [dosages not stated; not all routes stated]. The girl, started receiving induction chemotherapy with prednisolone, IM asparaginase [L-asparaginase] injection, vincristine, daunorubicin and methotrexate in December 2004. Five days after the first injection of asparaginase and 15 days after the prednisolone initiation, she developed moderate abdominal pain in the hypochondrium and left epigastrium. The girl received unspecified analgesic treatment, but symptoms progressed. On day 3 after the second asparaginase injection, she was hospitalised due to worsening epigastric pain, gas, bloating and persistent bilious vomiting. Lab tests revealed elevated levels of amylase and LDH. Based on the clinical presentation, she was diagnosed with acute pancreatitis. Per Balthazar’s CT score, the pancreatitis was classified as grade-B. She was treated with metronidazole, insulin, unspecified penicillin, gastric aspiration and parenteral nutrition with resultant improvement in her condition. She was discharged from the ICU after 5 days of admission. She continued chemotherapy without asparaginase leading to complete remission. In June 2005, her disease relapsed. Hence, she was started on unspecified second-line chemotherapy. However, she died 2 months later after failure of this chemotherapy [immediate cause of death not stated]. Tazi I, et al. Acute pancreatitis secondary to L-asparaginase (a case report). Eastern Mediterranean Health Journal 15: 475-479, No. 2, Apr 2009. Available from: URL: http:// 803499719 doi.org/10.26719/2009.15.2.475 [French; summarised from a translation]

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Editorial comment: Details of this case report have previously been published and processed for Adis PV [see Reactions 1273 p8; 801150326].

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Reactions 5 Sep 2020 No. 1820