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Abstract
Drug-induced pancreatitis accounts for 0.1∼2.0% of all pancreatitis cases. Generally, the mechanism of drug-induced pancreatitis is an immune reaction, accumulation of toxic material, and/or ischemia. However, how dapsone causes pancreatitis remains unclear. A 61-year-old man presented with a 2-week history of epigastric discomfort. He had taken dapsone for 2 months to treat psoriasis. Laboratory findings showed high blood glucose levels and metabolic acidosis; however, hemoglobin A1c was low. Serum amylase and lipase levels were elevated to 125/4,479 U/L. Abdominal computed tomography was indicative of pancreatitis. There was no causative history of pancreatitis and no other medication history except dapsone. Thus, we reached a diagnosis of diabetic ketoacidosis (DKA) followed by dapsone-induced pancreatitis. The patient fasted and was treated with insulin administration and fluid hydration in accordance with treatment guidelines. After treatment, amylase and lipase decreased and symptoms subsided, but insulin injection was required to control blood glucose levels. Drug-induced pancreatitis is a very rare adverse effect of dapsone. Only four cases of pancreatitis related to dapsone could be found in a PubMed search. Moreover, diabetes caused by dapsoneinduced pancreatitis has not been reported previously. Here, we report a case of DKA caused by dapsone-induced acute pancreatitis.
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Fig. 1.
(A) Abdominal and pelvic computed topography findings. Findings of indistinct pancreatic margins, heterogeneous pancreatic parenchymal tissue, and surrounding retroperitoneal fat stranding suggest acute pancreatitis. Obstruction of the biliary duct and pancreatic duct are not shown. (B) Abdominal ultrasonography findings. There are no focal lesions in the liver parenchyme. Also, there are no specific lesions in and the gallbladder (GB) or bile duct, nor any signs of GB stones.
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