背景：文献很少关注心包炎，儿童和青少年氯氮平治疗期间心包积液和胰腺炎。
方法：使用以下搜索对儿童氯氮平相关性心包炎和胰腺炎的病例进行了研究：1）PubMed（2023年6月16日），和2)世界卫生组织药物警戒数据库(2022年6月1日)，VigiBase。Vigibase使用称为信息分量(IC)的不成比例性的对数度量。
结果：PubMed搜索产生了3例氯氮平相关心包炎病例，1例胰腺炎病例和1例两者兼有。VigiBase提供了明显的氯氮平相关心包炎IC=3.6，IC025=2.9（预计仅3例，观察到22例）。VigiBase提供了显着的氯氮平相关胰腺炎IC=2.2，IC025=1.4（仅预期3例，而观察到16例）。在VigiBase中，青年时期氯氮平相关的心包炎和心包积液看起来相似，并且与心肌炎的连续性相似，如心肌炎，心包炎和胰腺炎似乎主要发生在氯氮平滴定期间。结合PubMed和VigiBase我们确定：1）29例至少可能的氯氮平相关心包炎/心包积液（6例可能和23例可能），包括7例心肌炎和22例无心肌炎，2）氯氮平相关性胰腺炎17例（明确1例，可能16例）。其中2例胰腺炎发生在用药过量期间。在任何氯氮平相关的心包炎和胰腺炎病例中均未发现致命结局。
结论：尽管文献中对氯氮平相关性心包炎和胰腺炎缺乏关注，结果表明，它们可能发生在青年时期，特别是在滴定过程中。在剂量滴定期间，心包炎和胰腺炎似乎是氯氮平相关炎症的形式。
BACKGROUND: The literature has paid very little attention to pericarditis, pericardial effusion and pancreatitis during clozapine treatment in children and adolescents.
METHODS: Cases of clozapine-associated pericarditis and pancreatitis in children were studied using searches in: 1) PubMed (June 16, 2023), and 2) the World Health Organization\'s pharmacovigilance database (June 1, 2022), VigiBase. VigiBase uses a logarithmic measure of disproportionality called the information component (IC).
RESULTS: The PubMed search yielded 3 clozapine-associated pericarditis cases, 1 pancreatitis case and 1 with both. VigiBase provided a significant clozapine-associated pericarditis IC = 3.6 with an IC025 = 2.9 (only 3 cases were expected while 22 were observed). VigiBase provided a significant clozapine-associated pancreatitis IC = 2.2 with an IC025 = 1.4 (only 3 cases were expected while 16 were observed). In VigiBase clozapine-associated pericarditis and pericardial effusion in youth looked similar and on a continuum with myocarditis, as myocarditis, pericarditis and pancreatitis appeared to occur mainly during clozapine titration. Combining PubMed and VigiBase we identified: 1) 29 cases of at least possible clozapine-associated pericarditis/pericardial effusion (6 probable and 23 possible) including 7 cases with and 22 without myocarditis, and 2) 17 cases of clozapine-associated pancreatitis (1 definite and 16 possible). Two of the pancreatitis cases occurred during overdoses. No fatal outcomes were found in any clozapine-associated pericarditis and pancreatitis cases.
CONCLUSIONS: Despite the lack of attention in the literature to clozapine-associated pericarditis and pancreatitis, results demonstrate that they can happen in youth, particularly during titration. Pericarditis and pancreatitis appear to be forms of clozapine-associated inflammation during dose titration.
