培门冬酶注射液致急性重症胰腺炎1例分析

One case of acute severe pancreatitis caused by pegaspargase and its etiology

目的 探讨培门冬酶引起急性重症胰腺炎的临床特点及可能影响因素,为肿瘤患儿临床用药提供参考。方法 分析1例T淋巴母细胞淋巴瘤患儿培门冬酶治疗后出现急性胰腺炎病例,经停药、禁食、予对症处理后恢复,评估后再次予培门冬酶治疗后再现急性胰腺炎。采用Naranjo评分并结合文献资料,分析诱发胰腺炎的危险因素。结果 根据患儿的临床表现及用药时间关联性,结合Naranjo评分9分,确定培门冬酶为引起急性胰腺炎的药物,同时高脂饮食可能是急性胰腺炎的诱因。结论 培门冬酶可致急性胰腺炎,治疗期间应强调低脂饮食,医护人员应加强对该药相关胰腺炎的防治认识。

Objective To explore the clinical characteristics and potential risk factors of severe acute pancreatitis caused by pegaspargase and caution clinicians against the adverse effect of this drug.Methods The clinical data of one child with T lymphoblastic lymphoma who developed acute severe pancreatitis after medication with pegaspargase was studied.After withdrawal of pegaspargase,fasting,and supplemental treatment,the patient’s symptoms were significantly relieved.After evaluation and repeated use of pegaspargase,acute pancreatitis reoccurred but improved as result of symptomatic treatment.The risk factors for pancreatitis were analyzed based on the Naranjo score and literature review.Results Based on the manifestations of acute pancreatitis,the relationship with the timing of medication,and a Naranjo score of 9,pegaspargase was confirmed as the cause of acute pancreatitis,and a high-fat diet might be a risk factor.Conclusion Clinicians should advance their understanding of and be alert to acute pancreatitis associated with pegaspargase.Low-fat diet should be recommended during treatment.