Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

L-asparaginase-induced pancreatitis has been reported during or closely following administration of the drug. Three cases of pseudocyst of the pancreas in two women and one man have previously been reported with the use of intravenous L-asparaginase. An adolescent male developed acute pancreatitis and pseudocyst of the pancreas 16 weeks after cessation of intramuscular L-asparaginase. Delayed pseudocyst of the pancreas can be a complication of intramuscular L-asparaginase.
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PMID:Delayed pancreatic pseudocyst formations. Long-term complication of L-asparaginase treatment. 713 89

The treatment of the acute lymphoblastic leukemia in childhood includes frequent administration of L-asparaginase by intravenous route. L-asparaginase is an enzyme produced by E. coli and Erwinia chrysanthemi strains. Adverse reactions produced by L-asparaginase are numerous, and pancreatitis is being the most severe. Children with the acute lymphoblastic leukemia were followed up for 2 years. Hyperglycaemia and glycosuria were noted in 10% of them resulting in L-asparaginase cessation or replacement by less toxic agents. The acute pancreatitis was produced in 8% of the patients, and was treated typically.
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PMID:[Acute pancreatitis in children with acute lymphoblastic leukemia treated with L-asparaginase]. 780 58

Pancreatitis following the administration of L-asparaginase (L-asp) has been well documented. However, the progression of such pancreatitis to pseudocyst formation in some patients has been rarely reported. The few reported cases have been teenagers, with the exception of one adult. All pseudocysts required surgical management. This report documents a pancreatic pseudocyst in a seven-year-old girl with acute lymphoblastic leukemia whose treatment regimen included L-asp. The pseudocyst was managed medically with nasogastric decompression, intravenous hyperalimentation, and antibiotics. The pseudocyst resolved spontaneously in one month without complication.
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PMID:L-asparaginase-related pancreatic pseudocyst: report of a case. 792 87

We show Escherichia coli derived L-asparaginase complications observed in 14 of 136 acute lymphoblastic leukemia patients during remission induction therapy according to St. Jude Children's Hospital Total XI Protocol. We observed hyperglycemia in six patients; two of them had accompanying ketoacidosis. One of the cases with ketoacidosis had peritonitis and pancreatitis. Central nervous system symptoms such as convulsions and depression with personality changes (in one case) were observed in four of these six hyperglycemic patients. Intracranial bleeding and ischemic infarction were shown in cranial computed tomographies in two cases. Hypersensitivity reactions were observed in seven patients. Patients were randomly assigned into two groups and treated with conventional dose steroids or high dose methylprednisolone. Although the frequency of hypersensitivity reactions were lower in the high dose methylprednisolone group, one patient in this group had an anaphylactic reaction. These findings once again high-light L-asparaginase complications which are not dose dependent and can be life threatening.
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PMID:Hyperglycemia, ketoacidosis and other complications of L-asparaginase in children with acute lymphoblastic leukemia. 799 65

Twenty-five patients with acute lymphoblastic leukemia [15 adults and 10 children] received standard treatment in which regular L-asparaginase was replaced for L-asparaginase of prolonged action [PEG-asparaginase]. The drug was administered once in two weeks in a dose 2500 IU/m2 for remission induction and consolidation or as a component of maintenance therapy. It was found that the response to primary PEG-asparaginase treatment or its use in the disease relapses produced the same response as regular L-asparaginase, being superior in convenience and feasibility of outpatient use. Side effects in the form of hypoproteinemia, hepatic toxicity and toxic pancreatitis [in children, 9 and 1 adults, respectively] were moderate and disappeared after 10-20-day discontinuation of the drug.
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PMID:[Use of long-acting L-asparaginase (PEG-asparaginase) in acute lymphoblastic leukemia]. 818 30

Hyperglycemia may occur as a complication in patients with leukemia during induction therapy with L-asparaginase and steroids. The reported incidence is about 10%. The present report concerns three patients with acute lymphoblastic leukemia (ALL), complicated by hyperglycemia. Their ages were 10, 12, and 9 years, respectively. Past histories were normal, with no diabetes mellitus or other endocrine disorders in their families. Case 1 was an obese boy who developed pancreatitis and diabetic ketoacidosis (DKA) in his remission induction therapy which had included both L-asparaginase and steroids. Cases 2 and 3 both presented with polyuria and elevated postprandial blood sugar. For all patients, insulin was administered to control their blood sugars; the maximal daily dosage of insulin dispensed was 2.1 U/kg, 0.5 U/kg, and 0.7 U/kg, respectively. Increased plasma insulin and C-peptide levels suggestive of insulin resistance were observed in Case 3. The outcome of hyperglycemia in these three patients was good. The symptoms of this complication may vary from mild glucose intolerance to severe, or even fatal, DKA. Thus, periodic determinations of urine glucose and postprandial blood sugar are important for early recognition to prevent further life-threatening consequences.
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PMID:Hyperglycemia induced by chemotherapeutic agents used in acute lymphoblastic leukemia: report of three cases. 828 94

A randomized clinical trial of combination chemotherapy for adult acute lymphoblastic leukemia (ALL) with doxorubicin, vincristine and prednisolone with and without L-asparaginase (AdVP vs L-AdVP) was conducted, involving 58 institutions throughout Japan. After reaching complete remission (CR), patients were treated with the same regimen for more than 2 years. Among 166 evaluable cases of the 198 cases enrolled, CR rates were 63.1% (53/84) with AdVP and 64.6% (53/82) with L-AdVP (P = 0.837). Median survival times and 7-year survival rates were 12.7 months and 21.2% with AdVP, and 16.0 months and 22.3% with L-AdVP (P = 0.955 by generalized Wilcoxon test [GW], P = 0.952 by log-rank test [LR]). Median disease-free survival times and 7-year survival rates were 13.5 months and 23.8% with AdVP and 17.0 months and 30.6% with L-AdVP, showing some increments for L-AdVP but no statistical significance (P = 0.141 by GW, P = 0.300 by LR). Among the cases of extramurally confirmed FAB subtypes, CR rates were 75.9% (63/83) for the L1 subtype and 51.3% (39/76) for the L2 subtype (P = 0.001). As to adverse effects, pancreatitis was complicated more frequently in L-AdVP than in AdVP (P = 0.039). Other side effects such as hyperbilirubinemia, diabetes mellitus, diarrhea and hypofibrinogenemia were observed more frequently with L-AdVP, but with no statistical significance. Thus, addition of a single course of L-asparaginase in the induction phase of combination chemotherapy with doxorubicin, vincristine and prednisolone did not significantly enhance the effect of antileukemic treatment of adult ALL.
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PMID:Nation-wide randomized comparative study of doxorubicin, vincristine and prednisolone combination therapy with and without L-asparaginase for adult acute lymphoblastic leukemia. 830 8

A comprehensive literature search was performed to collect all available data on drug-induced pancreatitis. Strong evidence for an association with acute pancreatitis has been described for anticholinesterases, calcium 2',3'-dideoxyinosine, estrogen, L-asparaginase, salicylates, thiazide-diuretics, valproic acid, and vinca alkaloids. Weak evidence has been found for antituberculous agents, azathioprine, biguanides, cisplatinum, cyclosporine A, H2-blocking agents, loop diuretics, 6-mercaptopurine, metronidazole, pentamidine, steroids, sulfonamides, sulindac and tetracycline. Many cases were associated with underlying conditions known to induce acute pancreatitis themselves. It is concluded that for none of the drugs studied the available data are consistent enough to support a definite association with acute pancreatitis. Nevertheless, the data suggest that drugs may be a trigger or a cofactor in inducing pancreatitis.
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PMID:Drug-induced acute pancreatitis: further criticism. 833 61

L-asparaginase has been used clinically for treatment of a wide variety of pediatric neoplastic diseases (e.g. acute lymphocytic leukemia, malignant lymphoma, etc.) A 14-year-old female patient, is a victim of acute lymphocytic leukemia, Pre T type. She got acute pancreatitis after the L-asparaginase therapy. We reported her clinical course and our management. It is concluded that early diagnosis of pancreatitis is usually difficult, because the symptoms are vague, physical findings may be minimal, and laboratory studies are frequently inconclusive until the injury is severe. Therefore, physicians must be cautious to the patient's chief complaint before administering the next dose of L-asparaginase, because it may occur more earlier than the laboratory or image studies and thus could be used to predict pancreatitis.
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PMID:Acute pancreatitis in association with L-asparaginase therapy: report of one case. 838 60

We reported a case of ALL complicated with acute pancreatitis caused by L-asparaginase (L-Asp). The patient was a 42-year-old man, who showed eosinophilia in peripheral blood and an increase of lymphoblast in bone marrow. He was diagnosed as ALL (L2) and treated by JALSG '87 protocol. Remission induction chemotherapy including L-Asp was administered by 5,000 IU i.v. for 10 days. The day after giving all dose of L-Asp, slight epigastralgia developed and then became severe. After two days, s-amylase was markedly elevated, and the patient was diagnosed as acute pancreatitis caused by L-Asp. He was treated conservatively, but hyperglycemia occurred. The epigastrial tumor was palpable and gradually grew in size. CT-scan and abdominal ultrasonography revealed pancreatic pseudocyst, so he was treated by percutaneous cyst drainage. The patient died of a relapse of ALL. The prophylaxis and early diagnosis of the pancreatitis and hyperglycemia caused by L-Asp are very difficult. We have to examine more cases and pay greater attention to the chemotherapy, including L-Asp.
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PMID:[A case of ALL complicated with acute pancreatitis and pancreatic pseudocyst caused by L-asparaginase ]. 842 80


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