Linezolid-Induced Pancreatitis Associated with Lactic Acidosis and Relative Hypoglycemia: A Rare Case Report

Gi Eun Kim; Soubiya Mohammed Rizwan Ansari; Ateeque Mohamed Ali; Ehab Adam; Mugahid Eltahir

doi:10.12890/2023_004041

Linezolid-Induced Pancreatitis Associated with Lactic Acidosis and Relative Hypoglycemia: A Rare Case Report

Eur J Case Rep Intern Med. 2023 Aug 31;10(10):004041. doi: 10.12890/2023_004041. eCollection 2023.

Authors

Gi Eun Kim¹, Soubiya Mohammed Rizwan Ansari¹, Ateeque Mohamed Ali², Ehab Adam¹, Mugahid Eltahir^{1

3}

Affiliations

¹ Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
² Weill Cornell Medicine-Qatar, Doha, Qatar.
³ Department of Medical Intensive Care Unit, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.

Abstract

Background: Linezolid is known to cause side effects, including nausea, diarrhea, and headaches of short duration. As extended use of linezolid is becoming more common, additional rare side effects should be considered.

Case presentation: A 68-year-old man hospitalized for osteomyelitis developed severe abdominal pain and altered mental status following five weeks of linezolid therapy. Laboratory studies showed very high lipase levels, lactic acidosis not responding to resuscitation, and relative hypoglycemia. All common causes of pancreatitis were ruled out, and a trial of linezolid withdrawal was done resulting in drastic improvement in the patient's clinical status.

Conclusions: For patients on extended course of linezolid who develop abdominal pain, drug-induced pancreatitis should be considered as a side effect, and a trial of withdrawal of linezolid should be undertaken.

Learning points: Linezolid can be associated with a rare but serious triad of adverse effects of pancreatitis, hypoglycemia, and lactic acidosis.Possible risk factors include a prolonged course of linezolid, renal dysfunction, and sepsis.

Keywords: Drug-induced pancreatitis; acute pancreatitis; linezolid side effect.