Possible Acute Pancreatitis in A Patient with COVID 19 Pneumonia

Öz

Acute pancreatitis (AP) can sometimes develop due to drug or toxin side effects, passage or compression of gallstones, viral infections, alcohol use, some metabolic disorders, and autoimmune diseases. Since the first case was detected in December 2019, with the increase in the number of infected cases of Corona virus disease 2019 (COVID-19), not only lung infection but also different clinical manifestations of the disease continued to be reported. Although respiratory symptoms are common symptoms of COVID-19, non-respiratory symptoms can sometimes develop. There may be patients presenting with gastrointestinal (GI) system symptoms such as nausea, vomiting, abdominal pain and diarrhea. Although very rare, there may be patients presenting with pancreatitis. In this case report, we aimed to present a 66-year-old patient who had abdominal pain at presentation and was diagnosed with possible AP associated with COVID-19.

Anahtar Kelimeler

• COVID 19
• SARS-CoV-2.
• Acut Pancreatitis

COVID 19 Pnömonisi Olan Bir Hastada Olası Akut Pankreatit

Öz

Akut pankreatit (AP); bazen ilaç veya toksin yan etkisine, safra kesesi taşlarının pasajı veya sıkışmasına, viral enfeksiyonlara, alkol kullanımına, bazı metabolik bozukluklara, otoimmün hastalıklara bağlı olarak gelişebilir. İlk vakanın tespit edildiği Aralık 2019 tarihinden itibaren Korona virüs hastalığı 2019 (COVID-19) enfekte vaka sayılarının artması ile hastalığın sadece akciğer enfeksiyonu olarak değil, farklı klinik tabloları da bildirilmeye devam etmiştir. Sık karşılaşılan COVID-19 semptomları solunumsal semptomlar olsa da bazen solunum dışı semptomlar da gelişebilir. Bulantı, kusma, karın ağrısı ve diyare gibi gastrointestinal (GI) sistem semptomları ile gelen hastalar olabilir. Çok nadir de olsa pankreatit ile gelen hastalar olabilir. Bu vaka sunumunda; 66 yaşında, başvuru şikayeti karın ağrısı olan, COVID-19 ilişkili olası AP tanısı alan bir olguyu sunmayı amaçladık.

Anahtar Kelimeler

• COVID 19
• SARS-CoV-2
• Akut Pankreatit

Kaynakça

1. Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis 2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–111. https://doi.org/10.1136/gutjnl-2012-302779
2. Çelik M, Demir M , Bulgurcu M , Karakuş A , Kavvasoğlu G . Klaritromisine Bağlı Gelişen Akut Pankreatit. Mustafa Kemal univ. tıp derg. 2015; 3(11): 38-42.
3. Avcı E, Ardahanlı İ, Öztaş E , Dişibeyaz S . COVID-19’da gastrointestinal semptomlar ile hastalığın seyri ve prognozu arasında bir ilişki var mı? Tek merkezli pilot çalışma. Akademik Gastroenteroloji Dergisi. 2020; 19(3): 103-108.
4. https://www.worldometers.info/coronavirus/ [İnternet]. [Erişim tarihi: 22.02.2021].
5. Mazrouei SSA, Saeed GA, Al Helali AA. COVID-19-associated acute pancreatitis: a rare cause of acute abdomen. Radiol Case Rep. 2020;15(9):1601-1603. https://doi.org/10.1016/j.radcr.2020.06.019.
6. Aloysius MM, Thatti A, Gupta A, Sharma N, Bansal P, Goyal H. COVID-19 presenting as acute pancreatitis. Pancreatology. 2020;20(5):1026-1027.
7. Gupta R, Patnaik I, Kumar A. Letter to the editor in response to COVID-19 presenting as acute pancreatitis. Pancreatology. 2020;20(5):1021-1022.
8. Cheung S, Delgado Fuentes A, Fetterman AD. Recurrent Acute Pancreatitis in a Patient with COVID-19 Infection. Am J Case Rep. 2020;21:e927076.

9. Kurihara Y, Maruhashi T, Wada T, Osada M, Oi M, Yamaoka K, et al. Pancreatitis in a Patient with Severe Coronavirus Disease Pneumonia Treated with Veno-venous Extracorporeal Membrane Oxygenation. Intern Med. 2020;59(22):2903-2906.
10. Wills SE, Beaufrere HH, Brisson BA. Pancreatitis and systemic coronavirus infection in a ferret (Mustela putorius furo). Comp Med. 2018;68(3):208–211.
11. Qian DH, Zhu GJ, Wu LZ, Hua GX. Isolation and characterization of a coronavirus from pigeons with pancreatitis. Am J Vet Res. 2006;67(9):1575-1579. https://doi.org/10.2460/ajvr.67.9.1575
12. Wang F, Wang H, Fan J, Zhang Y, Wang H, Zhao Q. Pancreatic Injury Patterns in Patients With Coronavirus Disease 19 Pneumonia. Gastroenterology. 2020 ;159(1):367-370. https://doi.org/10.1053/j.gastro.2020.03.055.
13. McNabb-Baltar J, Jin DX, Grover AS, Redd WD, Zhou JC, Hathorn KE, et al. Lipase Elevation in Patients With COVID-19. Am J Gastroenterol. 2020;115(8):1286-1288. https://doi.org/10.14309/ajg.0000000000000732.
14. Bineshfar N, Mirahmadi A, Karbasian F, Pourbakhtyaran E, Karimi A, Sarafi M. Acute Pancreatitis as a Possible Unusual Manifestation of COVID-19 in Children. Case Rep Pediatr. 2021;2021:6616211.
15. Dindar Demiray E, Yılmaz M, Alıravcı I, Alkan S . COVID-19-Akut Pankreatit İlişkisinin İncelenmesi. IGUSABDER. 2021; (13): 130-143.
16. Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin E, et al; Global COVID-19 Thrombosis Collaborative Group, Endorsed by the ISTH, NATF, ESVM, and the IUA, Supported by the ESC Working Group on Pulmonary Circulation and Right Ventricular Function. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020 ;75(23):2950-2973.
17. Akarsu C, Karabulut M, Aydin H, Sahbaz NA, Dural AC, Yegul D, et al. Association between Acute Pancreatitis and COVID-19: Could Pancreatitis Be the Missing Piece of the Puzzle about Increased Mortality Rates? J Invest Surg.1-7. Online ahead of print. doi: 10.1080/08941939.2020.1833263.
18. Ding Y, He L, Zhang Q, Huang Z, Che X, Hou J, et al. Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: implications for pathogenesis and virus transmission pathways. J Pathol. 2004;203(2):622-630.
19. Liu F, Long X, Zhang B, Zhang W, Chen X, Zhang Z. ACE2 expression in pancreas may cause pancreatic damage after SARS-CoV-2 infection. Clin Gastroenterol Hepatol. 2020;18(9):2128–2130. doi:10.1016/j.cgh.2020.04.040.
20. Troncone E, Salvatori S, Sena G, De Cristofaro E, Alfieri N, Marafini I, et al. Low Frequency of Acute Pancreatitis in Hospitalized COVID-19 Patients. Pancreas. 2021;50(3):393-398. doi: 10.1097/MPA.0000000000001770. PMID: 33835971.