Frusemide-induced acute pancreatitis: Report of a rare case

Sumaira Kanwal Rafiqui ¹, Mohamed Elmudathir Osman²

Keywords: Frusemide, Acute pancreatitis, Rechallenge, Liver cirrhosis

DOI: 10.18231/j.yjom.2024.015

DOI URL: http://doi.org/10.18231/j.yjom.2024.015

Publish Date: 11-09-2024

Pages: 163 - 165

Downloads: 3

Author Affiliation:

¹Dept. of Medicine, Hamad General Hospital, Doha, Qatar
²Dept. of Endocrinology, Hamad Medical Corporation, Doha, Qatar

Abstract

This paper reported a rare case of frusemide-induced acute pancreatitis in a 65-year-old female who presented to the emergency department with severe epigastric pain and vomiting for two days. Her medical history included type 2 diabetes mellitus and liver cirrhosis caused by hepatitis C virus infection, for which she was taking insulin and spironolactone. Ten days prior, she was prescribed frusemide for poorly controlled ascites. She had no history of alcoholism or gallbladder disease. However, two years ago, the patient developed acute pancreatitis. Upon reviewing her medical record, we found that her first acute pancreatitis episode occurred after she had been prescribed frusemide 40 mg daily for ascites control six days before the pancreatitis episode. Serum amylase was 1022 IU/L, and lipase was 3122 IU/L, while abdominal ultrasonography showed a contracted gallbladder without lithiasis and a normal biliary tree and liver. The patient was diagnosed with frusemide-induced acute pancreatitis. She received conservative management with analgesia, hydration, and fasting. Abdominal paracentesis was performed with an albumin replacement. In the following days, the patient remained stable and afebrile, and her symptoms improved. Consequently, she was discharged with strict instructions to avoid frusemide in the future.