Abstract：
OBJECTIVE: We describe a case of acute pancreatitis (AP) and hypofibrinogenemia associated with drug treatment with the aim to increase awareness of uncommon yet possibly life-threatening adverse reactions of tigecycline and furosemide.
METHODS: A 75-year-old Chinese male was hospitalized for acute non-ST-elevation myocardial infarction and acute heart failure. The patient underwent successful percutaneous coronary intervention and MitraClip. Furosemide was taken since admission. Because Acinetobacter baumannii was detected in the blood and sputum, the patient was treated with tigecycline from the 14th day of hospitalization. Abnormal pancreatitis parameters were observed, and pancreatic CT was undertaken 12 days after the treatment of tigecycline. AP was diagnosed and symptomatic treatment was carried out, but no significant improvement was observed. On the 33rd day of hospitalization, the patient presented with acute upper gastrointestinal bleeding and decreased levels of fibrinogen and platelets. After withdrawal of tigecycline, the coagulation and pancreatitis parameters improved significantly. However, the pancreatitis parameters increased again after stopping somatostatin. Therefore, somatostatin was given again for 1 day, and furosemide was discontinued. After that, the pancreatitis parameters returned to baseline levels after a slight recovery.
CONCLUSIONS: Clinicians should pay attention to clinical signs, symptoms, and pancreatic enzymes during tigecycline or furosemide treatment, especially when used in combination. In addition, regular monitoring of fibrinogen and platelet count during tigecycline treatment is suggested.
METHODS: A 75-year-old Chinese male was hospitalized for acute non-ST-elevation myocardial infarction and acute heart failure. The patient underwent successful percutaneous coronary intervention and MitraClip. Furosemide was taken since admission. Because Acinetobacter baumannii was detected in the blood and sputum, the patient was treated with tigecycline from the 14th day of hospitalization. Abnormal pancreatitis parameters were observed, and pancreatic CT was undertaken 12 days after the treatment of tigecycline. AP was diagnosed and symptomatic treatment was carried out, but no significant improvement was observed. On the 33rd day of hospitalization, the patient presented with acute upper gastrointestinal bleeding and decreased levels of fibrinogen and platelets. After withdrawal of tigecycline, the coagulation and pancreatitis parameters improved significantly. However, the pancreatitis parameters increased again after stopping somatostatin. Therefore, somatostatin was given again for 1 day, and furosemide was discontinued. After that, the pancreatitis parameters returned to baseline levels after a slight recovery.
CONCLUSIONS: Clinicians should pay attention to clinical signs, symptoms, and pancreatic enzymes during tigecycline or furosemide treatment, especially when used in combination. In addition, regular monitoring of fibrinogen and platelet count during tigecycline treatment is suggested.
摘要：
目的：我们描述了一例与药物治疗相关的急性胰腺炎（AP）和低纤维蛋白原血症，目的是提高对替加环素和呋塞米的罕见但可能危及生命的不良反应的认识。
方法：一名75岁的中国男性因急性非ST段抬高型心肌梗死和急性心力衰竭住院。患者接受了成功的经皮冠状动脉介入治疗和MitraClip。入院后服用呋塞米。因为在血液和痰中检测到鲍曼不动杆菌，患者从住院第14天开始接受替加环素治疗.观察胰腺炎参数异常，替加环素治疗后12天进行胰腺CT检查。确诊为AP并对症治疗,但没有观察到显著的改善。在住院的第33天，患者出现急性上消化道出血，纤维蛋白原和血小板水平降低。替加环素停药后,凝血和胰腺炎参数明显改善。然而,停止生长抑素后，胰腺炎参数再次增加。因此,再次给予生长抑素1天,并停用呋塞米。之后,胰腺炎参数在轻微恢复后恢复至基线水平.
结论：临床医生应注意临床体征，症状,替加环素或呋塞米治疗期间的胰腺酶，特别是在组合使用时。此外,建议在替加环素治疗期间定期监测纤维蛋白原和血小板计数。
方法：一名75岁的中国男性因急性非ST段抬高型心肌梗死和急性心力衰竭住院。患者接受了成功的经皮冠状动脉介入治疗和MitraClip。入院后服用呋塞米。因为在血液和痰中检测到鲍曼不动杆菌，患者从住院第14天开始接受替加环素治疗.观察胰腺炎参数异常，替加环素治疗后12天进行胰腺CT检查。确诊为AP并对症治疗,但没有观察到显著的改善。在住院的第33天，患者出现急性上消化道出血，纤维蛋白原和血小板水平降低。替加环素停药后,凝血和胰腺炎参数明显改善。然而,停止生长抑素后，胰腺炎参数再次增加。因此,再次给予生长抑素1天,并停用呋塞米。之后,胰腺炎参数在轻微恢复后恢复至基线水平.
结论：临床医生应注意临床体征，症状,替加环素或呋塞米治疗期间的胰腺酶，特别是在组合使用时。此外,建议在替加环素治疗期间定期监测纤维蛋白原和血小板计数。
