Aspirin as a cause of pancreatitis in patients with aspirin-exacerbated respiratory disease

Many patients with idiopathic pancreatitis or microlithiasis have recurrent attacks of acute pancreatitis. [...]stopping and starting a drug with recurrence of pancreatitis might be a coincidence and not a cause-and-effect relationship.4 Attempts to provide guidelines on drug/pancreatitis associatio...

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Bibliographic Details
Published in:Journal of allergy and clinical immunology 2012-06, Vol.129 (6), p.1687-1688
Main Authors: Stevenson, Donald D., MD, White, Andrew A., MD, Simon, Ronald A., MD
Format: Article
Language:English
Subjects:
Abdomen
Allergy and Immunology
Aspirin
Aspirin - adverse effects
aspirin-exacerbated respiratory disease
Cardiovascular disease
Drug dosages
drug reactions
Enzymes
Female
Humans
Male
nonsteroidal anti-inflammatory drugs
Pancreas
pancreatitis
Pancreatitis - etiology
Patients
Respiratory Tract Diseases - chemically induced
Respiratory Tract Diseases - complications
Statins
Ultrasonic imaging
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Description
Summary:Many patients with idiopathic pancreatitis or microlithiasis have recurrent attacks of acute pancreatitis. [...]stopping and starting a drug with recurrence of pancreatitis might be a coincidence and not a cause-and-effect relationship.4 Attempts to provide guidelines on drug/pancreatitis associations have been published.5,6 In one study a drug was assigned to class I if greater than 20 prior case reports of drug association with pancreatitis had been reported and at least 1 positive rechallenge result with the suspect drug had been documented.5 All the statins and 1 nonsteroidal anti-inflammatory drug, sulindac, are in class I. Ten or more case reports without any rechallenges were less probable (class II), and all others, with less than 10 case reports, were classified as possible (class III).5 In another classification, patterns of latency from the start of drug therapy to the onset of pancreatitis were added.6 Class I included drugs in which at least 1 case report described a recurrence of acute pancreatitis after rechallenge with the same drug. [...]that this patient had aspirin-induced pancreatitis, one would have to believe that moderate doses of aspirin, with a latency of 4 days, can cause pancreatitis but that very low doses cannot.
ISSN:0091-6749
1097-6825
DOI:10.1016/j.jaci.2012.04.016