Tamoxifen
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Hypertrigliceridaemia and severe acute pancreatitis: case report A 44-year-old woman developed hypertriglyceridaemia and severe acute pancreatitis during tamoxifen therapy [route of administration not stated] for breast cancer. The patient, who had undergone a radical mastectomy, started receiving radiotherapy and tamoxifen 20 mg/day. After 12 months, she was admitted to the ICU for acute respiratory distress syndrome. Investigations revealed bilateral pulmonary oedema and elevated triglyceride and amylase levels. A CT scan, which demonstrated fluid collection in the peripancreatic region and bilateral perirenal spaces, indicated acute pancreatitis grade E. Tamoxifen was discontinued. The woman was intubated and mechanically ventilated for 10 days, and was discharged home 2 months later. Her serum triglyceride levels normalised over the following weeks, and at her oneyear follow-up she was asymptomatic. The woman was re-challenged with tamoxifen 10 months later [dosage not stated]. After a few days she was readmitted to hospital for acute pancreatitis. She had a triglyceride level of 10.3 g/L. She responded well to supportive therapy and pain control, and was eventually discharged with instructions to avoid tamoxifen in the future. Author comment: "The temporal relationship between tamoxifen administration and the elevated pancreatic enzyme concentrations, the rapid improvement of values after stopping the drug, the recurrence of pancreatitis when the drug was readministered led us to classify our case as probable tamoxifen-induced pancreatitis. According to Badalov’s classification, tamoxifen is included in class I." Sakhri J, et al. Severe acute pancreatitis due to tamoxifen-induced hypertriglyceridemia with positive rechallenge. Journal of the Pancreas 11: 803037157 382-384, Jul 2010 - Tunisia
0114-9954/10/1318-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 11 Sep 2010 No. 1318
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