Hypertriglyceridemia Independent Propofol-Induced Pancreatitis
Abstract
Context Propofol can cause acute pancreatitis related to hypertriglyceridemia, however, other mechanisms may also exist. Case report A 71-year-old male on propofol infusion in the intensive care setting, developed acute pancreatitis as confirmed biochemically and by imaging. He did not have any elevation of triglycerides and on propofol re-challenge, had recurrence of pancreatitis with the absence of triglyceride elevation. Conclusion We report a case of hypertriglyceridemia independent propofol induced pancreatitis possibly related to an idiosyncratic reaction and propose that this drug to be reassigned as a class Ia drug as an etiologic factor for acute pancreatitis.
Image: Edematous acute pancreatitis.
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References
Lankisch PG, Dröge M, Gottesleben F. Drug induced acute pancreatitis: incidence and severity. Gut. 1995 Oct;37(4):565-7. [PMID 7489946]
Muniraj T, Gajendran M, Thiruvengadam S, Raghuram K, Rao S, Devaraj P. Acute pancreatitis. Disease a Month. 2012 Mar;58(3):98-144. [PMID 22370054]
Badalov N, Baradarian R, Iswara K, Li J, Steinberg W, Tenner S. Drug-induced acute pancreatitis: an evidence-based review. Clinical Gastroenterology and Hepatology. 2007 Jun;5(6):648-61. [PMID 17395548]
Toskes PP. Hyperlipidemic pancreatitis. Gastroenterology Clinics of North America. 1990 Dec;19(4):783-91. [PMID 2269517]
Fortson MR, Freedman SN, Webster PD 3rd. Clinical assessment of hyperlipidemic pancreatitis. American Journal of Gastroenterology 1995 Dec;90(12):2134-9. [PMID 8540502]
Eddleston JM, Shelly MP. The effect on serum lipid concentrations of a prolonged infusion of propofol--hypertriglyceridaemia associated with propofol administration. Intensive Care Medicine. 1991;17(7):424-6. [PMID 1774398]
Lowrey TS, Dunlap AW, Brown RO, Dickerson RN, Kudsk KA. Pharmacologic influence on nutrition support therapy: use of propofol in a patient receiving combined enteral and parenteral nutrition support. Nutrition in Clinical Practice. 1996 Aug;11(4):147-9. [PMID 9070015]
Mateu J, Barrachina F. Hypertriglyceridaemia associated with propofol sedation in critically ill patients. Intensive Care Medicine. 1996 Aug;22(8):834-5. [PMID 8880259]
Barrientos-Vega R, Mar Sánchez-Soria M, Morales-García C, Robas-Gómez A, Cuena-Boy R, Ayensa-Rincon A. Prolonged sedation of critically ill patients with midazolam or propofol: impact on weaning and costs. Critical Care Medicine. 1997 Jan;25(1):33-40. [PMID 8989173]
Miller LJ, Wiles-Pfeifler R. Propofol for the long-term sedation of a critically ill patient. American Journal of Critical Care. 1998 Jan;7(1):73-6. [PMID 9429686]
Wingfield TW. Pancreatitis after propofol administration: is there a relationship? Anesthesiology. 1996 Jan;84(1):236-7. [PMID 8572343]
Leisure GS, O'Flaherty J, Green L, Jones DR. Propofol and postoperative pancreatitis. Anesthesiology. 1996 Jan;84(1):224-7. [PMID 8572338]
Metkus AP, Trabulsy PP, Schlobohm RS, Hickey MS. A firefighter with pancreatitis. Lancet. 1996 Dec 21-28;348(9043):1702. [PMID 8973434]
Possidente CJ, Rogers FB, Osler TM, Smith TA. Elevated pancreatic enzymes after extended propofol therapy. Pharmacotherapy. 1998 May-Jun;18(3):653-5. [PMID 9620119]
Jawaid Q, Presti ME, Neuschwander-Tetri BA, Burton FR. Acute pancreatitis after single-dose exposure to propofol: a case report and review of literature. Digestive Diseases and Sciences. 2002 Mar;47(3):614-8. [PMID 11911351]
Metheny B. Adaptation of new vacuum-pressure denture processing system to dental implant fabrication. Trends and Techniques in Contemporary and Dental Lab. 1989 Apr;6(3):36-8. [PMID 2697077]
Kumar AN, Schwartz DE, Lim KG. Propofol-induced pancreatitis: recurrence of pancreatitis after rechallenge. Chest. 1999 Apr;115(4):1198-9. [PMID 10208230]
Dönmez A, Arslan G, Pirat A, Demirhan B. Is pancreatitis a complication of propofol infusion? European Journal of Anaesthesiol.ogy 1999 Jun;16(6):367-70. [PMID 10434163]
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