Acute necrotizing pancreatitis in the setting of CMV viremia and AIDS: a case report and review of literature from 1980 to 2012

JOP. 2012 Nov 10;13(6):705-11. doi: 10.6092/1590-8577/1197.

Abstract

Context: Cytomegalovirus (CMV)-induced pancreatitis in patients with AIDS is a known entity with poor prognosis.

Case report: We report a case of a 43-year-old woman with AIDS and CMV viremia who was evaluated for hypotension and found to have severe necrotizing pancreatitis. The authors have also conducted a MEDLINE search for CMV-induced pancreatitis from 1980 to 2012 and reviewed the pertinent results.

Discussion: Until mid-1990s in the United States, pancreatitis due to CMV was mainly diagnosed at autopsy in AIDS patients. However, presumably due to the advent of antiretroviral therapy, there has since been a significant decline in the number of reported cases among these individuals. Rather, our review revealed that the occurrence of CMV-induced pancreatitis has since been described in a variety of clinical settings, ranging from patients on corticosteroid therapy to immunocompetent persons.

Conclusions: Clinicians need a high index of suspicion to timely diagnose CMV-induced pancreatitis as patients often present with non-specific signs and symptoms. As it occurred in our case, early intervention is crucial and may alter the outcome in such patients.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications*
  • Adult
  • Biomarkers
  • Cytomegalovirus Infections / complications*
  • Diagnosis, Differential
  • Female
  • Humans
  • Pancreatitis, Acute Necrotizing / diagnosis
  • Pancreatitis, Acute Necrotizing / etiology*
  • Pancreatitis, Acute Necrotizing / therapy
  • Tomography, X-Ray Computed
  • Viremia / complications*

Substances

  • Biomarkers