A Case of Drug‐Induced Pancreatitis

TL;DR

A 35-year-old woman developed acute pancreatitis after taking ciprofloxacin, highlighting the rare but possible side effect of drug-induced pancreatitis.

Contribution

This case report adds to the limited literature on ciprofloxacin-induced pancreatitis and emphasizes the importance of early recognition and drug discontinuation.

Findings

The patient showed rapid clinical improvement after discontinuing ciprofloxacin and receiving supportive care.

Ciprofloxacin was identified as the probable cause using causality assessment tools like Naranjo and Badalov.

Common causes of pancreatitis were ruled out, supporting a drug-induced etiology.

Abstract

Drug‐induced pancreatitis (DIP) is a rare but important cause of acute abdominal pain, and ciprofloxacin‐associated cases are exceptionally uncommon. We report a 35‐year‐old woman with no significant medical history who developed severe epigastric pain radiating to the back, accompanied by nausea and vomiting, 3 days after initiating self‐prescribed ciprofloxacin for diarrhea. Laboratory tests revealed markedly elevated serum amylase and lipase, and contrast‐enhanced CT confirmed acute interstitial pancreatitis. Common causes including gallstones, alcohol use, hypertriglyceridemia, hypercalcemia, and viral hepatitis were excluded. Ciprofloxacin was discontinued, and the patient was managed with intravenous fluids, bowel rest, and analgesia, leading to rapid clinical and biochemical improvement within 4 days. Given the temporal relationship, exclusion of alternative etiologies, and supportive causality assessments (Naranjo Adverse Drug Reaction Probability Scale & Badalov Classification), ciprofloxacin was considered the probable cause. This case underscores the importance of considering DIP in patients presenting with new‐onset abdominal pain during fluoroquinolone therapy, as prompt drug withdrawal and supportive care can result in swift recovery and prevent complications.

Acute pancreatitis may rarely occur within days of starting ciprofloxacin. Clinicians should suspect drug‐induced pancreatitis in patients with new abdominal pain during fluoroquinolone therapy, as prompt discontinuation and supportive care can lead to rapid recovery.

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