A Case of Diabetic Ketoacidosis Caused by Dapsone-Induced Acute Pancreatitis.

Seo,  Jung Bum; Shin,  Kwang Hee; Kim,  Min Ji; Park,  Ji Eun; Park,  Keun Kyu; Kim,  Jung Guk; Lee,  In Kyu; Kim,  Sung Woo

doi:2016.17.4.282

J Korean Diabetes > Volume 17(4); 2016 > Article

Case Report

The Journal of Korean Diabetes 2016;17(4):282-287.
DOI: https://doi.org/10.4093/jkd.2016.17.4.282 Published online December 30, 2016.

Dapsone 사용 후 급성췌장염을 동반한 당뇨병성 케톤산증 1예

서정범, 신광희, 김민지, 박지은, 박근규, 김정국, 이인규, 김성우

A Case of Diabetic Ketoacidosis Caused by Dapsone-Induced Acute Pancreatitis.

Jung Bum Seo, Kwang Hee Shin, Min Ji Kim, Ji Eun Park, Keun Kyu Park, Jung Guk Kim, In Kyu Lee, Sung Woo Kim

¹Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.
²Research Institute of Pharmaceutical Sciences, College of Pharmacy, Kyungpook National University, Daegu, Korea.
³Division of Endocrinology and Metabolism, Department of Internal Medicine, Cha Gumi Medical Center, CHA University, Gumi, Korea. sungwoocap@naver.com

Abstract

Drug-induced pancreatitis accounts for 0.1~2.0% of all pancreatitis cases. Generally, the mechanism of drug-induced pancreatitis is an immune reaction, accumulation of toxic material, and/or ischemia. However, how dapsone causes pancreatitis remains unclear. A 61-year-old man presented with a 2-week history of epigastric discomfort. He had taken dapsone for 2 months to treat psoriasis. Laboratory findings showed high blood glucose levels and metabolic acidosis; however, hemoglobin A1c was low. Serum amylase and lipase levels were elevated to 125/4,479 U/L. Abdominal computed tomography was indicative of pancreatitis. There was no causative history of pancreatitis and no other medication history except dapsone. Thus, we reached a diagnosis of diabetic ketoacidosis (DKA) followed by dapsone-induced pancreatitis. The patient fasted and was treated with insulin administration and fluid hydration in accordance with treatment guidelines. After treatment, amylase and lipase decreased and symptoms subsided, but insulin injection was required to control blood glucose levels. Drug-induced pancreatitis is a very rare adverse effect of dapsone. Only four cases of pancreatitis related to dapsone could be found in a PubMed search. Moreover, diabetes caused by dapsone-induced pancreatitis has not been reported previously. Here, we report a case of DKA caused by dapsoneinduced acute pancreatitis.

Key Words: Dapsone, Diabetes, Pancreatitis