S1575 A Case of Acute Pancreatitis Associated With the Novel Severe Acute Respiratory Syndrome Coronavirus-2

Autor: Neera Sinha, S. Samad, N. St Cyr, Abdul Basit, Muhammad Abdullah
Rok vydání: 2020
Předmět:
Zdroj: American Journal of Gastroenterology. 115:S801-S801
ISSN: 1572-0241
0002-9270
DOI: 10.14309/01.ajg.0000708348.01457.bd
Popis: INTRODUCTION: Acute pancreatitis is a frequent cause of hospital admissions The most common causes are gallstones and alcohol, while 10% are infectious To our knowledge, we present the 4th case of acute pancreatitis caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV2) CASE DESCRIPTION/METHODS: A 60-year-old African American male with uncontrolled hypertension presented with weakness and nausea for one week He denied alcohol use, herbal medications and reported non-compliance to his prescribed medications Vitals: BP 188/98 mmHg, HR 110/min Physical exam revealed epigastric tenderness Labs were significant for positive SARS-CoV- 2, T bili:0 3mg/dl, IGG:1145mg/dl, IGM: 77mg/dl, calcium:8 3mg/dl, triglyceride:440mg/dl, Lipase 4800U/L and D-Dimer 2418 ng/ml Ultrasound abdomen was negative for gallstones CT abdomen revealed peripancreatic fat stranding He was started on intravenous hydration and oxygen supplementation His abdominal pain resolved and he tolerated a normal solid diet He had a prolonged hospital course due to increasing oxygen requirements Repeat imaging revealed possible pancreatic pseudocyst formation He was diagnosed with SARS-CoV-2 pancreatitis as a diagnosis of exclusion DISCUSSION: SARS-CoV-2 typically presents with respiratory symptoms As more data emerges, gastrointestinal symptoms (GI) are being reported which is believed to be caused by feco-oral transmission route Studies show that SARS-CoV-2, uses Angiotensin converting enzyme -2 (ACE2), a viral receptor found in the intestinal epithelia, to enter host cells downregulating the expression of ACE2 leading to intestinal inflammation 10% of acute pancreatitis cases are infectious, although the exact incidence of viral pancreatitis is unknown Studies show viral pancreatitis as a consequence of direct destruction of the pancreatic acinar cells and we hypothesize that SARS-CoV-2 via binding to ACE2, uses a similar mechanism Also, it is associated with the formation of microthrombi, which may impair microcirculation causing inflammation and ischemia of the pancreas Earlier, patients were admitted primarily based on respiratory-related symptoms This case brings to our attention the incidence of GI symptoms and possible complications associated with the virus It shows the challenges associated with treatment of both, in which fluid overload with subsequent acute respiratory distress syndrome is a concern This case serves to increase awareness of a possible association of the novel SARS-CoV-2 with pancreatitis (Figure Presented)
Databáze: OpenAIRE
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