Re: Vinorelbine-Induced Pancreatitis: a Case Report

Extract

Tester et al. (1) recently published information on a case of vinorelbineinduced acute pancreatitis. We report a similar case of acute pancreatitis following vinorelbine administration in a 74- year-old woman. This patient was admitted to our institution in August 1996. She had multiple pulmonary metastases from breast cancer after having undergone potentially curative modified radical mastectomy 3 months previously. Because of her advanced age and the presence of cardiovascular comorbidity, including coronary heart disease and a history of cerebral infarction 15 years ago, palliative chemotherapy with vinorelbine at an age-adjusted dose of 25 mg/m² per week was initiated. Two days after the first administration of drug, the patient became icteric and complained of nausea and emesis along with upper abdominal pain.

Analysis of laboratory values revealed that the patient had an elevated serum bilirubin level (4 mg/dL) as well as a threefold increase in the levels of transaminases. In addition, she had an amylase level of 190 U/L (reference value = 120 U/L) and a serum lipase level of 434 U/L (reference value = 200 U/L) consistent with acute pancreatitis. Radiologic examinations including ultrasound and computed tomography scan of the abdomen showed no pathologic findings. Her symptoms resolved with symptomatic treatment within 3 days, and laboratory levels returned to normal values within 5 days.