Azathioprine induced pancreatitis in a patient with co-existing autoimmune pancreatitis and hepatitis

JOP. 2011 May 6;12(3):250-4.


Context: Azathioprine induced pancreatitis usually runs a benign self limited course with rapid disappearance of signs and symptoms upon with drawl of the drug. Azathioprine is used in treating relapses in patients with autoimmune pancreatitis and maintenance of remission in autoimmune hepatitis. Acute pancreatitis complicated by symptomatic pseudocysts requiring drainage is not usually associated with drug induced pancreatitis. The risk of azathioprine use in patients with underlying disease of pancreas including autoimmune pancreatitis is unclear.

Case report: We report here a case of an African American patient with co-existing autoimmune pancreatitis and autoimmune hepatitis who developed azathioprine induced acute pancreatitis complicated by a large symptomatic pseudocyst compressing the duodenum requiring a cystoduodenostomy.

Conclusions: Future studies to investigate the risk of azathioprine induced pancreatitis in the presence of underlying disease of the pancreas including autoimmune pancreatitis are required to further understand the safety of azathioprine in this sub group of patients.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / chemically induced
  • Abdominal Pain / complications
  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / drug therapy
  • Azathioprine / adverse effects*
  • Azathioprine / therapeutic use
  • Hepatitis, Autoimmune / complications*
  • Hepatitis, Autoimmune / drug therapy
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Middle Aged
  • Pancreatic Pseudocyst / chemically induced
  • Pancreatic Pseudocyst / complications
  • Pancreatitis / chemically induced*
  • Pancreatitis / complications


  • Immunosuppressive Agents
  • Azathioprine