• Clinical and Experimental Pediatrics
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• v.60 no.10
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• pp.333-336
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• 2017

Coxsackievirus A16 (CA16), which primarily causes hand, foot, and mouth disease (HFMD), is associated with complications, such as encephalitis, acute flaccid paralysis, myocarditis, pericarditis, and shock. However, no case of pancreatitis associated with CA16 has been reported in children. We report a case of CA16-associated acute pancreatitis in a 3-year-old girl with HFMD. She was admitted because of poor oral intake and high fever for 1 day. Maculopapular rashes on both hands and feet and multiple vesicles on the soft palate were observed on physical examination. She was treated conservatively with intravenous fluids. On the fourth hospital day, she had severe abdominal pain and vomiting. The serum levels of amylase and lipase were remarkably elevated (amylase, 1,902 IU/L; reference range, 28-100 IU/L; lipase, >1,500 IU/L; reference range, 13-60 IU/L), and ultrasonography showed diffuse swelling of the pancreas with a small amount of ascites. The real-time reverse transcription polymerase chain reaction result from a stool sample was positive for CA16. CA16 can cause acute pancreatitis, and should be considered in the differential diagnosis of abdominal pain in children with HFMD.

• Clinical and Experimental Pediatrics
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• v.46 no.11
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• pp.1128-1130
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• 2003

Retinoic acid has been used successfully as a differentiating agent in acute promyelocytic leukemia and neuroblastoma. However, some adverse effects have been recognized, such as headaches, dry skin and retinoic acid syndrome, a life threatening acute cardiorespiratory disorder. Acute pancreatitis with hyperlipidemia has rarely been reported. We experienced a case of acute pancreatitis with hyperlipidemia in a neuroblastoma patient after retinoic acid therapy for 21 months. Although the patient was ordered nothing by mouth and total parenteral nutrition was administrated, she died of disseminated intravascular coagulopathy and pulmonary hemorrhage, possibly because of oral intake during her recovery period.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.3
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• pp.209-215
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• 2015

Mycoplasma pneumoniae is responsible for approximately 20% to 30% of community-acquired pneumonia, and is well known for its diverse extrapulmonary manifestations. However, acute necrotizing pancreatits is an extremely rare extrapulmonary manifestation of M. pneumoniae infection. A 6-year-old girl was admitted due to abdominal pain, vomiting, fever, and confused mentality. Acute necrotizing pancreatitis was diagnosed according to symptoms, laboratory test results, and abdominal computed tomography scans. M. pneumoniae infection was diagnosed by a 4-fold increase in antibodies to M. pneumoniae between acute and convalescent sera by particle agglutination antibody assay. No other etiologic factors or pathogens were detected. Despite the occurrence of a large infected pseudocyst during the course, the patient was able to discharge without morbidity by early aggressive supportive care. This is the first case in Korea of a child with acute necrotizing pancreatitis associated with M. pneumoniae infection.

• Korean Journal of Veterinary Research
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• v.39 no.5
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• pp.951-960
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• 1999

We performed this study to evaluate the potential clinical marker of urinary trypsinogen-2 together with amylase, lipase and urinary amylase creatinine clearance ratio (ACCR) for the diagnosis of acute pancreatitis in dogs. In the experiment on daily changing patterns of amylase, lipase and ACCR measurements in experimentally induced pancreatitis dogs, compared to values measured in pre-induction state, significant difference was seen in amylase until 5th day of induction, and for lipase significant difference was found during the 7th day of observation period (p < 0.05). No significant difference was found in ACCR for the study period (p > 0.05). On SDS-PAGE analysis of urine from experimentally induced pancreatitis dog, The 26kd band was markedly increased compared with that of normal state and that band was confirmed trypsinogen-2 using substrate interaction and isoelectric focusing assay after being eluted. When assessing the appearance of 26kd band on urine SDS-PAGE 87.1% (range: 50~100%) of experimentally induced pancreatitis dogs showed positive results, whereas no corresponding band was seen in dog without pancreatic disorders. With this result, determination of urinary trypsinogen-2 assay was found to have a high diagnostic value with a 70% of sensitivity and 100% of specificity as a routine test for pancreatitis, although the detection of trypsinogen-2 in urine can be varied on the progression stage of pancreatitis at the initial visit to animal clinic. We therefore suggest that the promising results in this study be used for the development of dipstick test for detecting acute pancreatitis in the future research.

• Journal of Yeungnam Medical Science
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• v.33 no.1
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• pp.33-36
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• 2016

Metformin, commonly prescribed for type 2 diabetes, is considered safe with minimal side-effect. Acute pancreatitis is rare but potentially fatal adverse side-effect of metformin. We report a patient on hemodialysis with metformin-related acute pancreatitis and lactic acidosis. A 62-year-old woman with diabetic nephropathy and hypertension presented with nausea and vomiting for a few weeks, followed by epigastric pain. At home, the therapy of 500 mg/day metformin and 50 mg/day sitagliptin was continued, despite symptoms. Laboratory investigations showed metabolic acidosis with high levels of lactate, amylase at 520 U/L (range, 30-110 U/L), and lipase at 1,250 U/L (range, 23-300 U/L). Acute pancreatitis was confirmed by computed tomography. No recognized cause of acute pancreatitis was identified. Metformin was discontinued. Treatment with insulin and intravenous fluids resulted in normalized amylase, lipase, and lactate. When she was re-exposed to sitagliptin, no symptoms were reported.

• The Korean Journal of Physiology and Pharmacology
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• v.19 no.4
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• pp.299-307
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• 2015

Severe acute pancreatitis (SAP) is normally related to multiorgan dysfunction and local complications. Studies have found that local pancreatic renin-angiotensin system (RAS) was significantly upregulated in drug-induced SAP. The present study aimed to investigate the effects of angiotensin II receptors inhibitor valsartan on dual role of RAS in SAP in a rat model and to elucidate the underlying mechanisms. 3.8% sodium taurocholate (1 ml/kg) was injected to the pancreatic capsule in order for pancreatitis induction. Rats in the sham group were injected with normal saline in identical locations. We also investigated the regulation of experimentally induced SAP on local RAS expression in the pancreas through determination of the activities of serum amylase, lipase and myeloperoxidase, histological and biochemical analysis, radioimmunoassay, fluorescence quantitative PCR and Western blot analysis. The results indicated that valsartan could effectively suppress the local RAS to protect against experimental acute pancreatitis through inhibition of microcirculation disturbances and inflammation. The results suggest that pancreatic RAS plays a critical role in the regulation of pancreatic functions and demonstrates application potential as AT1 receptor antagonists. Moreover, other RAS inhibitors could be a new therapeutic target in acute pancreatitis.

• Biomolecules & Therapeutics
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• v.4 no.3
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• pp.257-264
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• 1996

The protective effect of human urinary trypsin inhibitor (UTI) on acute pancreatitis was studied in beagle model. After pancreatitis was experimentally induced in beagle dogs by infusing trypsin and sodium taurocholate into the accessory pancreatic ducts under laprotomy, effects of UTI were compared to those of aprotinin. Routine physical examination, hematology and blood chemistry values were used as parameters and checked on a periodical basis during the experiment. At the end of experiment, surviving animals were sacrificed and liver, kidney, and pancreas were histologically examined. The results of this study warrant the development of UTI as new therapeutics for acute pancreatitis.

• Pediatric Infection and Vaccine
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• v.30 no.2
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• pp.104-110
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• 2023

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) mainly causes respiratory symptoms such as fever, cough, sputum, and rhinorrhea, as well as digestive symptoms such as diarrhea, vomiting, and abdominal pain in children. In this report, we describe a case of a child with a SARS-CoV-2 infection who presented with epigastric pain and was subsequently diagnosed with acute pancreatitis without any concomitant infections in other organs. The epigastric pain was relieved with goal-directed vigorous fluid therapy for acute pancreatitis for 24 hours, and the serological and radiological findings normalized after two months. Acute pancreatitis should be considered as a differential diagnosis when a child with a history of COVID-19 visits the hospital with epigastric pain.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.1
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• pp.61-64
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• 2017

Recurrent acute pancreatic attacks is a rare clinical condition (2-5% of all acute pancreatis) in children and is mainly idiopathic in most cases. Sometimes it may be associated with congenital anomalies, metabolic diseases or hereditary conditions. Isovaleric acidemia (IVA) is a rare autosomal recessive amino acid metabolism disorder associated with isovaleryl coenzyme A dehydrogenase deficiency presenting the clinical findings such metabolic acidosis with increased anion gap, hyperammonemia, ketonemia, hypoglycemia, "the odor of sweaty feet," abdominal pain, vomiting, feeding intolerance, shock and coma. Recurrent acute pancreatitis associated with IVA have been rarely reported. Herein; we report a child who admitted with recurrent acute pancreatic attacks and had the final diagnosis of IVA. Mutation analysis revealed a novel homozygous mutation of (p.E117K [c.349G>A]) in the IVA gene. Organic acidemias must kept in mind in the differential diagnosis of recurrent acute pancreatic attacks in children.

• The Korea Journal of Herbology
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• v.25 no.4
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• pp.39-45
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• 2010

Objectives : This study was undertaken to compare the effect of Foeniculi Fructus and Lonicerae Flos extract on the cerulein-induced acute pancreatitis in rats. Methods : Acute pancreatitis was induced by intraperitoneal injection of cerulein. Foeniculi Fructus extract (FE; 300 mg/kg) and Lonicerae Flos extract (LE; 300 mg/kg) were injected 2hr before induction of acute pancreatitis. Rats were sacrificed 6hr after first injection of cerulein. The severity of pancreatitis was assessed by measuring pancreatic weight/body weight ratio, neutrophil, lymphocyte, serum amylase activity, platelet activating factor (PAF) activity, tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) activity, interleukin 6 (IL-6) activity and by histological assessments of inflammatory cell infiltration. Results : 1. The pancreatic weight/body weight ratios of FE and LE group compared with the control group were decreased significantly. 2. The neutrophil content ratio of FE and LE group compared with the control group were decreased. 3. The lymphocyte content ratio of FE and LE group compared with the control group were increased significantly. 4. The activities of serum amylase of FE and LE group compared with the control group were decreased significantly. 5. The activities of serum PAF of FE and LE group compared with the control group were decreased significantly. 6. The activities of TNF-${\alpha}$ of FE and LE group compared with the control group were decreased significantly. 7. The activities of IL-6 of FE and LE group compared with the control group were decreased significantly. 8. The pancreas injected with FE and LE showed reduction of swelling of acinar cells, inflammation and vacuolization than the control group on light microscopic observation. Conclusions : These results suggest that Foeniculi Fructus and Lonicerae Flos extract have an effect to suppress inflammation on cerulein-induced acute pancreatitis in rats. But there are no significant differences between Foeniculi Fructus extract and Lonicerae Flos extract.