humulene and Pancreatitis

In addition to the growing interest of different cannabinoids for therapeutic purposes, the safety profile of these substances has changed, with the recent identification of new events such as acute pancreatitis.. The aim of this study was to characterize cannabinoid-related acute pancreatitis, based on the recent literature and the analysis of pharmacovigilance data available worldwide.. Nine national and international pharmacovigilance databases were requested for individual case safety reports of acute pancreatitis related to cannabinoid exposure. A systematic review was performed searching in PubMed. Twenty-two individual case safety reports were identified in the pharmacovigilance databases and 51 in the literature, corresponding to a predominantly young male population (74% of men, median age 28 interquartile range [21-39]) using recreational Cannabis sativa with high intensity. A therapeutic purpose was identified in 13 cases (including tetrahydrocannabinol, cannabidiol, and dronabinol). The outcome was often favorable after dechallenge (except three deaths), and frequent recurrences were observed in the case of rechallenge or sustained consumption. Eleven cross-sectional studies and one ecological study showed an increasing trend of cannabis use in in-patients with acute pancreatitis, with a significantly lower in-hospital mortality.. This review underlines that acute pancreatitis is a potential adverse effect of cannabinoid use. It remains often unrecognized and can occur during recreational or therapeutic use. The development of the therapeutic use of cannabinoids in frail patients deserves a better investigation of the benefit-risk ratio of these different products.

Topics: Acute Disease; Adult; Cannabidiol; Cannabinoids; Cannabis; Cross-Sectional Studies; Dronabinol; Humans; Male; Pancreatitis

Cannabis use has been steadily rising in the United States and can have multiple adverse effects, including cannabis-induced acute pancreatitis. This study aims to collate and highlight the significant demographics, clinical presentation, and outcomes in patients with cannabis-induced acute pancreatitis.. A systematic literature search of electronic databases for peer-reviewed articles was conducted. After an initial search, we found 792 articles through different electronic databases. After manually removing duplicates and articles that did not meet the criteria, 25 articles were included in our review.. A total of 45 patients were studied, 35 (78%) cases were male and 10 (22%) cases were female, showing male predominance. The mean age of all participants was 29.2 ± 10.3 years. The most common presenting symptoms were abdominal pain 21 of 21 (100%), nausea 17 of 21 (81%), and vomiting 12 of 20 (60%). Ultrasound was normal in the majority of patients, with findings of mild pancreatitis. Computerized tomography scans revealed pancreatic edema and inflammation in 7 of 20 (35%) patients, and findings of necrotizing pancreatitis and complex fluid collection were visualized in 3 of 20 (15%) patients. Dilatation of intrahepatic or extrahepatic biliary ducts was not seen in any patients. The overall prognosis was good, with reported full recovery.. Cannabis should be included in the differential diagnosis for the etiology of acute pancreatitis, which would help in early intervention and treatment for the mitigation of the rapidly progressive disease.

Topics: Acute Disease; Adolescent; Adult; Analgesics; Cannabinoid Receptor Agonists; Cannabis; Female; Hallucinogens; Humans; Male; Pancreatitis; Young Adult

Cannabis is an illegal drug that has been under the spotlight in recent years, due to its vast array of effects on different biological systems. The role of cannabis has been investigated in the management of pain in acute pancreatitis (AP), even though some studies suggest that it may have a causative effect in this pathology and could be considered the underlying etiology in some cases of idiopathic AP. In this case report, we discuss the case of a young man who presented with three different episodes of AP, with apparently no significant history of alcohol and drug consumption, and with no evidence of a biliary, genetic or, autoimmune etiology. During the third episode, in which he had developed a voluminous pseudocyst, treated trough ultrasound (EUS)-guided drainage, he admitted consumption of cannabis daily. The Naranjo score resulted to be 6 (confirming the possible causality), and it was suggested to the patient to avoid cannabis consumption. Since then, he did not develop any other AP episodes. In summary, cannabis should be considered among the possible AP etiologies, as its causative identification and interruption may significantly improve the course of several idiopathic APs.

Topics: Adult; Cannabinoids; Cannabis; Humans; Male; Pancreatitis

Cannabis is the most frequently consumed illicit drug in the world, with higher prevalence under the age of 35 years. Cannabis was first reported as a possible cause of acute pancreatitis (AP) in 2004. The aim of this systematic review is to examine cannabis use as an etiology of AP.. A search using PubMed/Medline, Embase, Scopus, and Cochrane was performed without language or year limitations to May 1, 2016. Search terms were "Cannabis" and "Acute Pancreatitis" with all permutations. The search yielded 239 results. Acute pancreatitis was defined by meeting 2 of 3 Revised Atlanta Classification criteria. Cannabis-induced AP was defined by preceding use of cannabis and exclusion of common causes of AP when reported. Sixteen papers met inclusion criteria dating from 2004 to 2016.. There were 26 cases of cannabis-induced AP (23/26 men; 24/26 under the age of 35 y). Acute pancreatitis correlated with increased cannabis use in 18 patients. Recurrent AP related temporally to cannabis use was reported in 15 of 26. There are 13 reports of no further AP episodes after cannabis cessation.. Cannabis is a possible risk factor for AP and recurrent AP, occurring primarily in young patients under the age of 35 years. Toxicology screens should be considered in all patients with idiopathic AP.

Topics: Acute Disease; Adolescent; Adult; Cannabis; Female; Humans; Male; Pancreatitis; Risk Factors; Young Adult

Marijuana is a widely used illicit substance among young adults and its abuse has been reported worldwide. Marijuana is a rare trigger of acute myocardial infarction and acute pancreatitis. We present a 25-year-old man with acute pancreatitis subsequently complicated by acute ST-elevation myocardial infarction (STEMI), which was associated with marijuana abuse. This case highlights the need and importance of awareness among public about this rare but potentially lethal adverse effect. Also, it draws attention when clinicians confront patients with history of substance abuse, they should be alert to the possibility of concurrent occurrence of serious medical conditions that may be adverse effects of substance use. Acute pancreatitis with concurrent acute STEMI is a rare situation but is a challenge for many emergency physicians, and it can lead to trouble outcomes if it not be quickly diagnosed and properly managed. We demonstrate successful management in this complicated patient with primary angioplasty.

Topics: Acute Disease; Adult; Cannabis; Electrocardiography; Humans; Male; Myocardial Infarction; Pancreatitis

Topics: Acute Disease; Adult; Cannabinoids; Cannabis; Humans; Male; Marijuana Smoking; Pancreas; Pancreatitis; Tomography Scanners, X-Ray Computed

The aim of this study was to identify the prevalence of cannabis use among all patients admitted with acute pancreatitis (AP) in the United States and to investigate the impact of cannabis use on AP mortality, morbidity, and cost of care.. The National Inpatient Sample database from 2003 to 2013 was queried for all patients with AP and active exposure to cannabis. Outcomes included in-hospital mortality, length of stay, inflation adjusted charges, acute kidney injury, acute respiratory distress syndrome, and shock. Results were adjusted for age, sex, race, Charlson comorbidity index, median income quartile, and hospital characteristics.. More than 2.8 million patients with AP patients were analyzed. Cannabis-exposed (CE) patients' prevalence was 0.3%. Patients exposed to cannabis were younger and mostly males compared with non-cannabis-exposed patients. After adjusting for these factors, the CE group had significantly lower inpatient mortality compared with the noncannabis group (odds ratio, 0.17; 95% confidence interval, 0.06-0.53). Cannabis-exposed patients also had decreased length of stay, inflation-adjusted charges, acute kidney injury, ileus, shock, acute respiratory distress syndrome, and parenteral nutrition requirement.. Cannabis-exposed hospitalized patients with AP had lower age-adjusted, mortality, morbidity, and hospitalization-cost than non-cannabis-exposed patients.

Topics: Acute Disease; Adult; Cannabis; Comorbidity; Female; Hospital Costs; Hospital Mortality; Hospitalization; Humans; Inpatients; Length of Stay; Male; Marijuana Smoking; Middle Aged; Pancreatitis; Prevalence; United States

Topics: Acute Disease; Cannabis; Chronic Disease; Humans; Pancreatitis

Topics: Acute Disease; Cannabis; Chronic Disease; Humans; Pancreatitis

Twenty-percentage of acute pancreatitis (AP) cases is labeled as idiopathic. Cannabis remains the most frequently used illicit drug in the world. The aim of this study was to identify the prevalence of cannabis use among all patients with a first episode of AP, particularly in those labeled as idiopathic etiology, and determine any effect on AP severity.. Retrospective cohort of all consecutive patients admitted with a first episode of AP at a large tertiary referral hospital from 01/2013 through 12/2014. AP was identified by ICD9 code, or lipase ≥ 3 times the upper limit of normal and abdominal pain consistent with AP. Cannabis users (CU) were identified via history or urine toxicology.. Four hundred and sixty patients were included. 54% were men, with a mean age of 48 years (range 17-89 years). Forty-eight patients (10%) were identified as CU. After adjusting for admission SIRS, age, and gender, cannabis use was not found to be an independent risk factor for persistent SIRS, AKI, ARDS, pancreatic necrosis, mortality, ICU admission, length of stay, in-hospital infections, nor recurrent AP. Of note, AKI was least common among non-CU compared to CU (OR 0.4; p = 0.02; CI 0.2-0.9) and non-CU had a higher admission BISAP score (≥ 2) compared to CU (OR 2.5; p = 0.009; CI 1.2-4.9).. This is the largest study to date examining cannabis use in AP. Cannabis use was found across almost all etiologies of AP with a prevalence of 10% (48 cases), and in 9% (9 cases) of so-called idiopathic AP cases in this cohort, which could account as an association for approximately 2% of all AP cases. Cannabis use did not independently impact AP severity or mortality.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cannabis; Chicago; Female; Humans; Male; Middle Aged; Pancreatitis; Retrospective Studies; Young Adult

Topics: Acute Disease; Adolescent; Adult; Cannabis; Female; Humans; Male; Middle Aged; Pancreatitis; Prospective Studies; Young Adult

Topics: Acute Disease; Adult; Cannabis; Humans; Male; Marijuana Abuse; Pancreatitis

Acute pancreatitis is a common disease. Despite the frequent use of cannabis worldwide, only six reports have described cases of acute pancreatitis secondary to the use of tetrahydrocannabinoid (THC). Here we describe two cases of THC-induced pancreatitis. The first case occurred in a 38-year-old man with multiple admissions for THC-induced pancreatitis; the second case involved a 22-year-old man with no previous medical history. In both cases, other possible causes of acute pancreatitis were ruled out.

Topics: Acute Disease; Cannabis; Hospitalization; Humans; Pancreatitis

Drugs of all types are related to the etiology of pancreatitis in approximately 2% of cases. However, there have been very few reports of acute pancreatitis associated with cannabis use in the general population.. This report is the first such case in our country, and involves a 22-year-old North African man who presented to our emergency department with transfixiant epigastric abdominal pain, nausea and vomiting. The patient denied any past or familial medical history, was taking no medications chronically and had no history of trauma. The patient admitted to smoking one pack of cigarettes a day and occasional cannabis use, and no alcohol consumption. Biological and morphological explorations found Balthazar grade-A acute pancreatitis with no biliary dilatation or obstruction. The etiological workup was normal and, on repeat questioning, the patient admitted to being a regular and excessive user of cannabis, and to having done so 2 days before the abdominal pain.. The use of cannabis is frequently seen worldwide and even in North Africa, and regular users, especially young adults, should be informed of the risk of this possible cannabis-induced pancreatic disease. This case should also be borne in mind, although the association of cannabis with pancreatitis is problematic because of the difficulty in monitoring cannabinoids in the body and the illegality of cannabis use and, consequently, getting patients to admit to using it.

Topics: Acute Disease; Cannabis; Humans; Male; Marijuana Abuse; Pancreatitis; Young Adult

There are no previous reports of acute pancreatitis associated with cannabis use in the general population. Drugs of all types are related to the aetiology of pancreatitis in approximately 1.4-2.0% of cases.. We report the case of a 29 year old man who presented with acute pancreatitis after a period of heavy cannabis smoking. Other causes of the disease were ruled out. The pancreatitis resolved itself after the cannabis was stopped and this was confirmed by urinary cannabinoid metabolite monitoring in the community.. To our knowledge this is the first description of a case of cannabis induced pancreatitis. However, the link is difficult to establish and further evidence is required to prove the association.

Topics: Acute Disease; Adult; Cannabis; Humans; Male; Pancreatitis