entecavir and Alcoholism

In most cases clinical profile of acute hyperlipidemic pancreatitis is a preexisting lipoprotein abnormality associated to second risk factors such as alcohol abuse, diabetes mellitus or medications that can induce hypertrygliceridemia. We report a case of a young male affected by chronic hepatitis B virus infection admitted to Emergency Department due to acute abdominal pain, vomiting and fever. The patient was in antiretroviral treatment with entecavir; moreover he was affected by diabetes mellitus and he presented a past history of alcohol abuse. Laboratory tests demonstrated hyperglycemia, severe metabolic acidosis and hypertriglyceridemia, whereas abdominal computed tomography scan revealed peripancreatic edema: hyperlipidemic pancreatitits was supposed and the patient was admitted to the intensive care unit. Considering its possible role in the pathogenesis of pancreatitis, entecavir was interrupted and total of 3 sections of plasmapheresis were performed, allowing clinical resolution and prevention of pancreatic damage. The possible pathogenetic role of entecavir is discussed.

Topics: Abdominal Pain; Acute Disease; Adenine; Adult; Alcoholism; Antiretroviral Therapy, Highly Active; Critical Care; Diabetes Mellitus, Type 2; Fever; Guanine; Hepatitis B, Chronic; Humans; Hyperlipidemias; Hypertriglyceridemia; Male; Organophosphonates; Pancreatitis; Plasmapheresis; Reverse Transcriptase Inhibitors; Tenofovir; Tomography, X-Ray Computed; Triglycerides