Pancreatitis Developing in the Context of Acute Hepatitis: A Literature Review

  • Hossein Khedmat Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences. Tehran, Iran
  • Mohammad Ebrahim Ghamar-Chehreh Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences. Tehran, Iran
  • Shahram Agah Colorectal Research Center, Iran University of Medical Sciences. Tehran, Iran
  • Aghdas Aghaei Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences. Tehran, Iran
Keywords: Hepatitis E, Pancreatitis


Despite strong evidence suggestive of associations between hepatic diseases and pancreas injury, a potential relationship between acute hepatitis and acute pancreatitis has not been a matter of review; which we focused on in the current paper. Some of the main findings of this review article are: fulminant hepatitis failure represents the highest incident rate of hepatitis-related acute pancreatitis; so a screening program might be indicative in these patients. Specific characteristics of HAV-related pancreatitis are that it is a benign condition with no reported mortality; and a male preponderance in the incidence, with females developing in older ages and having shown the signs of both conditions simultaneously. The incidence of acute pancreatitis in HBV infection is the lowest, but the mortality was the highest. HEV-related acute pancreatitis was most likely to represent pseudocysts and there was an apparent ethnic-priority with Indian descents, the only reported cases in the literature. Hepatitis-related pancreatitis in liver transplant recipients was most frequent in HBV infected patients; and in IFN-induced pancreatitis, cessation of the drug was most effective in treatment, with no catastrophic event reported.

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Miroux C, Vausselin T, Delhem N. Regulatory T cells in HBV and HCV liver diseases: implication of regulatory T lymphocytes in the control of immune response. Expert Opin Biol Ther 2010; 10:1563-72. [PMID: 20932226]

Kitaoka S, Shiota G, Kawasaki H. Serum levels of interleukin-10, interleukin-12 and soluble interleukin-2 receptor in chronic liver disease type C. Hepatogastroenterology. 2003; 50:1569-74. [PMID: 14571788]

Jie Z, Liang Y, Hou L, Dong C, Iwakura Y, Soong L, Cong Y, Sun J. Intrahepatic innate lymphoid cells secrete IL-17A and IL-17F that are crucial for T cell priming in viral infection. J Immunol 2014; 192:3289-300. [PMID: 24600029]

Seki E, Schwabe RF. Hepatic Inflammation and Fibrosis: Functional Links and Key Pathways. Hepatology 2014. [PMID: 25066777]

Klöppel G, Sipos B, Zamboni G, Kojima M, Morohoshi T. Autoimmune pancreatitis: histo- and immunopathological features. J Gastroenterol 2007; 18:28-31. [PMID: 17520220]

Sass DA, Shakil AO. Fulminant hepatic failure. Liver Transpl 2005; 11:594-605. [PMID: 15915484]

Balakrishnan V, Nair P, Radhakrishnan L, Narayanan VA. Tropical pancreatitis - a distinct entity, or merely a type of chronic pancreatitis? Indian J Gastroenterol 2006; 25:74-81. [PMID: 16763335]

Jin Y, Gao H, Chen H, Wang J, Chen M, Li G, Wang L, Gu J, Tu H. Identification and impact of hepatitis B virus DNA and antigens in pancreatic cancer tissues and adjacent non-cancerous tissues. Cancer Lett 2013; 335:447-54. [PMID: 23499889]

Parbhoo SP, Welch J, Sherlock S. Acute pancreatitis in patients with fulminant hepatic failure. Gut 1973; 14: 428. [PMID: 4716531]

Kuo PC, Plotkin JS, Johnson LB. Acute pancreatitis and fulminant hepatic failure. J Am Coll Surg 1998; 187: 522-8. [PMID: 9809570]

Ede RJ, Moore KP, Marshall WJ, Williams R. Frequency of pancreatitis in fulminant hepatic failure using isoenzyme markers. Gut 1988; 29:778-81. [PMID: 2454877]

Mottram AR, Lazio MP, Bryant SM. Lepiota subincarnata J.E. Lange induced fulminant hepatic failure presenting with pancreatitis. J Med Toxicol 2010; 6:155-7. [PMID: 20532846]

Lee WM. Acute liver failure. Semin Respir Crit Care Med 2012; 33:36-45. [PMID: 22447259]

Jain P, Nijhawan S, Rai RR, Nepalia S, Mathur A. Acute pancreatitis in acute viral hepatitis. World J Gastroenterol 2007; 13:5741-4. [PMID: 17963301]

Mishra A, Saigal S, Gupta R, Sarin SK. Acute pancreatitis associated with viral hepatitis: a report of six cases with review of literature. Am J Gastroenterol 1999; 94:2292-5. [PMID: 10445566]

Lopez Morante A, Rodriguez de Lope C, San Miguel G, Pons Romero F. Acute pancreatitis in hepatitis A infection. Postgrad Med J 1986; 62:407-8. [PMID: 3763554]

Garty BZ, Kanner D, Danon YL. Pancreatitis associated with hepatitis A viral infection. J Pediatr 1995; 127:669. [PMID: 7562301]

Rana SK, Singh R, Aggarwal B, Kumar S. Acute pancreatitis in hepatitis A infection in a 10-year-old boy. Ped Infect Dis 2013; 5:172-174.

Shrier LA, Karpen SJ, McEvoy C. Acute pancreatitis associated with acute hepatitis A in a young child. J Pediatr 1995; 126: 57-9. [PMID: 7815225]

Basaranoglu M, Balci NC, Klör HU. Gallbladder sludge and acute pancreatitis induced by acute hepatitis A. Pancreatology 2006; 6: 141-4. [PMID: 16354962]

El-Sayed R, El-Karaksy H. Acute pancreatitis complicating acute hepatitis A virus infection. Arab J Gastroenterol. 2012; 13: 184-5. [PMID: 23432988]

Moleta DB, Kakitani FT, Lima AS, França JC, Raboni SM. Acute pancreatitis associated with acute viral hepatitis: case report and review of literature. Rev Inst Med Trop Sao Paulo 2009; 51: 349-51. [PMID: 20209272]

Yuen MF, Chan TM, Hui CK, Chan AO, Ng IO, Lai CL. Acute pancreatitis complicating acute exacerbation of chronic hepatitis B infection carries a poor prognosis. J Viral Hepat 2001; 8:459-64. [PMID: 11703578]

Shlomovitz E, Davies W, Cairns E, Brintnell WC, Goldszmidt M, Dresser GK. Severe necrotizing pancreatitis following combined hepatitis A and B vaccination. CMAJ 2007; 176:339-42. [PMID: 17261831]

Cavallari A, Vivarelli M, D'Errico A, Bellusci R, Scarani P, DeRaffele E, Nardo B, Gozzetti G. Fatal necrotizing pancreatitis caused by hepatitis B virus infection in a liver transplant recipient. J Hepatol 1995; 22:685-90. [PMID: 7560862]

Buffet C, Naveau S, Chaput JC, Etienne JP, Papoz L. Hepatitis B specific markers in chronic alcoholic pancreatitis. Dig Dis Sci 1982; 27:572-7. [PMID: 7083995]

Chen CH, Changchien CS, Lu SN, Wang JH, Hung CH, Lee CM. Lamivudine treatment for recurrent pancreatitis associated with reactivation of chronic B hepatitis. Dig Dis Sci 2002; 47:564-7. [PMID: 11911343]

Eugene C, Cadranel JF, Bergue A, Anciaux ML. Acute pancreatitis associated with non-A-non-B hepatitis. Report of a case. J Clin Gastroenterol 1990; 12:195-7. [PMID: 2109006]

Alvares-Da-Silva MR, Francisconi CF, Waechter FL. Acute hepatitis C complicated by pancreatitis: another extrahepatic manifestation of hepatitis C virus? J Viral Hepat. 2000; 7:84-6. [PMID: 10718948]

Deniel C, Coton T, Brardjanian S, Guisset M, Nicand E, Simon F. Acute pancreatitis: a rare complication of acute hepatitis E. J Clin Virol 2011; 51:202-4. [PMID: 21628104]

Somani SK, Ghosh A, Awasthi G. Severe acute pancreatitis with pseudocyst bleeding due to hepatitis E virus infection. Clin J Gastroenterol 2009; 2:39-42.

Jaroszewicz J, Flisiak R, Kalinowska A, Wierzbicka I, Prokopowicz D. Acute hepatitis E complicated by acute pancreatitis: a case report and literature review. Pancreas 2005; 30:382-4. [PMID: 15841052]

Makharia GK, Garg PK, Tandon RK. Acute pancreatitis associated with acute hepatitis E infection. Trop Gastroenterol 2003; 24:200-1. [PMID: 15164533]

Bhagat S, Wadhawan M, Sud R, Arora A. Hepatitis viruses causing pancreatitis and hepatitis: a case series and review of literature. Pancreas 2008; 36:424-7. [PMID: 18437090]

Thapa R, Biswas B, Mallick D, Ghosh A. Acute pancreatitis—complicating hepatitis E virus infection in a 7-year-old boy with glucose 6 phosphate dehydrogenase deficiency. Clin Pediatr (Phila) 2009; 48:199-201. [PMID: 19129425]

Krokos NV, Karavias D, Tzakis A, Tepetes K, Ramos E, Todo S, Fung JJ, Starzl TE. Acute pancreatitis after liver transplantation: incidence and contributing factors. Transpl Int 1995; 8:1-7. [PMID: 7534081]

Sinha S, Jha R, Lakhtakia S, Narayan G. Acute pancreatitis following kidney transplantation - role of viral infections. Clin Transplant 2003; 17:32-6. [PMID: 12588319]

Gaburri PD, Chebli JM, Quinet de Andrade Perez LV, Quinet de Andrade L. Autoimmune pancreatitis and hepatitis: an uncommon association. Am J Gastroenterol 2000; 95:2391-4. [PMID: 11007255]

Chaudhari S, Park J, Anand BS, Pimstone NR, Dieterich DT, Batash S, Bini EJ. Acute pancreatitis associated with interferon and ribavirin therapy in patients with chronic hepatitis C. Dig Dis Sci 2004; 49:1000-6. [PMID: 15309891]

Appelros S, Borgström A. Incidence, aetiology and mortality rate of acute pancreatitis over 10 years in a defined urban population in Sweden. Br J Surg 1999; 86:465-70. [PMID: 10215815]

Andersson R, Andersson B, Haraldsen P, Drewsen G, Eckerwall G. Incidence, management and recurrence rate of acute pancreatitis. Scand J Gastroenterol. 2004; 39:891-4. [PMID: 15513389]

Tahan V, Tahan G, Dane F, Uraz S, Yardim M. Acute pancreatitis attributed to the use of pegylated interferon in a patient with chronic hepatitis C. J Gastrointestin Liver Dis 2007; 16:224-5. [PMID: 17592576]

Eland IA, Rasch MC, Sturkenboom MJ, Bekkering FC, Brouwer JT, Delwaide J, Belaiche J, Houbiers G, Stricker BH. Acute pancreatitis attributed to the use of interferon alfa-2b. Gastroenterology. 2000; 119:230-3. [PMID: 10889173]

Cecchi E, Forte P, Cini E, Banchelli G, Ferlito C, Mugelli A. Pancreatitis induced by pegylated interferon alfa-2b in a patient affected by chronic hepatitis C. Emerg Med Australas 2004; 16: 473-5. [PMID: 15537413]

Roncal-Jimenez CA, Lanaspa MA, Rivard CJ, Nakagawa , Sanchez-Lozada LG, Jalal D, et al. Sucrose induces fatty liver and pancreatic inflammation in male breeder rats independent of excess energy intake. Metabolism. 2011; 60: 1259-1270. [PMID: 21489572]

Azizi A, Naguib NN, Mbalisike E, Farshid P, Emami AH, Vogl TJ. Liver metastases of pancreatic cancer: role of repetitive transarterial chemoembolization (TACE) on tumor response and survival. Pancreas 2011; 40:1271-5. [PMID: 21975434]

Pezzilli R, Andreone P, Morselli-Labate AM, Sama C, Billi P, Cursaro C, Barakat B, Gramenzi A, Fiocchi M, Miglio F, Bernardi M. Serum pancreatic enzyme concentrations in chronic viral liver diseases. Dig Dis Sci 1999; 44:350-5. [PMID: 10063922]

Baqiyatallah University of Medical Sciences. Tehran, Iran
How to Cite
KhedmatH., Ghamar-ChehrehM., AgahS., & AghaeiA. (2015). Pancreatitis Developing in the Context of Acute Hepatitis: A Literature Review. JOP. Journal of the Pancreas, 16(2), 104-109.