No abstract available.
Extremities* ; Sarcoma*

Drug-induced pancreatitis is now recognized as a distinct, although uncommon, entity. Azathioprine has been incriminated as a causative agent of acute pancreatitis. We report a 36-year-old female who developed acute pancreatitis in the course of treatment with azathioprine for rheumatoid arthritis. She was admitted due to epigastric pain, radiating to the back, for four days. Serum amylase and lipase levels were 226U/L (normal : 30-110U/L) and 1300U/L(normal : 23-300U/L), respectively. The abdominal ultrasonogram and CT scan revealed diffuse enlargement of the pancreas. We diagnosed it as acute pancreatitis. There was no history of alcohol use or gallbladder disease. We considered drugs, especially azathioprine, as the cause of acute pancreatitis. The patient was treated conservatively with intravenous fluid and analgesics. The symptoms subsided within three days. Thirteen days later, azathioprine was resumed. After six hours, the patient complained of epigastric pain. The elevated level of serum lipase(542U/L) confirmed the recurrence of pancreatitis. Her symptoms subsided when azathioprine intake stopped, and the serum lipase level returned to normal within four days.
Adult ; Amylases ; Analgesics ; Arthritis, Rheumatoid* ; Azathioprine ; Female ; Gallbladder Diseases ; Humans ; Lipase ; Pancreas ; Pancreatitis* ; Recurrence ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND/AIMS: The aims of this study were to determine subgoups of functional dyspesia and to evaluate the short-term effect of cisapride in patients with functional dyspepsia in Korea. METHODS: 1025 patients, with a mean age of 42.6 years, with symptoms of functional dyspepsia, were recruited consecutively and upper gastrointestinal symptoms were investigated by interview in 41 hospitals in Korea. In an open, multicenter trial, 1025 patients received Smg of cisapride three times a day (TID) for at least .2 weeks for the treatment of symptoms of functional dyspepsia. When necessary, the dose of cisapride was increased to 10mg TID and the duration of therapy was extended to 4 weeks. RESULTS: The most frequently reported symptoms of functional dyspepsia were epigastric discomfort or fullness (85%), bloating (70%), belching (53%), early satiety (52%) and epigastric pain (46%) retrospectively. Subgroups of functional dyspepsia were as follows; dysmotility-like 73.5%, ulcer-like 39.7%, reflux-like 13.0%, and unspecified dyspepsia 14.0%. However, 33.2% of subjects with functional dyspepsia could be classified into more than one subgroup. Upper gastrointestinal symptoms were decreased to average 50.3% (range; 42.2 to 59.2%) after 2 weeks of cisapride treatment and to 25% (19.2 to 29.9%) after 4 weeks. cisapride therapy resulted in good or excellent improvement in 59.0% of the patients after two weeks, in 75% of patients after 4 weeks. Adverse events were occurred in 52 patients (5.8% of all patients), most commonly, loose stools or diarrhea (3.5%), abdominal pain (1.1%), and dizziness (0.3%). The majority of adverse events was mild and transient in nature and led to premature discontinuation of treatment in 4 patients. CONCLUSIONS: Although the majorities of patients with functional dyspepsia have dysmotility like symptoms in Korea, there is such overlap among the dyspepsia subgroups. Most patients responded well to a short therapeutic trial with cisapride without significant side effects.
Abdominal Pain ; Cisapride* ; Diarrhea ; Dizziness ; Dyspepsia* ; Eructation ; Humans ; Korea* ; Retrospective Studies