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💊Drug Induced pancreatitis (DIP) by @AshkarMotaz from @WUGastro soon returning as @MayoClinicGIHep staff #IMPACT #gitwitter
🥇See tweet 5 for the current classification dx!
📚Hx of DIP: Understanding of DIP has evolved since it was first described in 1950s-60s on case reports
🥇See tweet 5 for the current classification dx!
📚Hx of DIP: Understanding of DIP has evolved since it was first described in 1950s-60s on case reports
🥇First drug-induced acute pancreatitis (AP) classification came out in '96
Subclassified as - definitive, probable, and possible DIP
Limitations of '96 classification:
1⃣DIP is UNCOMMON
2⃣DIP NOT different from AP 2/2 other causes
4⃣Drug re-challenge often not possible
Subclassified as - definitive, probable, and possible DIP
Limitations of '96 classification:
1⃣DIP is UNCOMMON
2⃣DIP NOT different from AP 2/2 other causes
4⃣Drug re-challenge often not possible
🌟DIP classification was updated again in 2006 based on evidence & pattern of clinical presentation.
New challenges‼️
1⃣Inadequate dx criteria for AP
2⃣? ruling our common causes of AP
3⃣Lack of rechallenge
4⃣Idiopathic, microlithiasis, genetic causes intersecting with DIP dx
New challenges‼️
1⃣Inadequate dx criteria for AP
2⃣? ruling our common causes of AP
3⃣Lack of rechallenge
4⃣Idiopathic, microlithiasis, genetic causes intersecting with DIP dx
🌟DIP Mechanisms:
- Duct obstruction -> edema -> ↓blood flow
- Acinar cell injury -> enzyme release
- Defective intracellular transport
‼️Results in premature activation of pancreatic enzymes -> AP‼️
- Duct obstruction -> edema -> ↓blood flow
- Acinar cell injury -> enzyme release
- Defective intracellular transport
‼️Results in premature activation of pancreatic enzymes -> AP‼️
🌟DIP classification was updated again in 2020
🎯DIP is primarily a diagnosis of exclusion
1⃣AP Develops during drug treatment phase.
2⃣No other causes are present
3⃣AP Resolves upon drug discontinuation
4⃣AP Recurs with drug re-administration
doi:10.1371/journal.pone.0231883
🎯DIP is primarily a diagnosis of exclusion
1⃣AP Develops during drug treatment phase.
2⃣No other causes are present
3⃣AP Resolves upon drug discontinuation
4⃣AP Recurs with drug re-administration
doi:10.1371/journal.pone.0231883
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