1. Home
  2. Vol 26, No 2 (2025)
  3. Abubakar

A Rare Case Of Acute Pancreatitis Cause by Newly Diagnosed Graves’ Disease: A Successful Therapeutic Option

Azzaki Abubakar(1), Fauzi Yusuf(2), Desi Maghfirah(3), Andrie Gunawan(4), Hendra Zufry(5), Meutia Nailan Edward(6), Khek Yu Ho(7),


(1) Gastroenterohepatology Division, Department of Internal Medicine, Faculty of Medicine, Syiah Kuala University, Banda Aceh, Aceh, 23111, Indonesia / Gastroenterohepatology Division, Departemen of Interna Medicine, General Hospital dr. Zainoel Abidin, Banda Aceh, Aceh, 23111, Indonesia
(2) Gastroenterohepatology Division, Department of Internal Medicine, Faculty of Medicine, Syiah Kuala University, Banda Aceh, Aceh, 23111, Indonesia / Gastroenterohepatology Division, Departemen of Interna Medicine, General Hospital dr. Zainoel Abidin, Banda Aceh, Aceh, 23111, Indonesia
(3) Gastroenterohepatology Division, Department of Internal Medicine, Faculty of Medicine, Syiah Kuala University, Banda Aceh, Aceh, 23111, Indonesia / Gastroenterohepatology Division, Departemen of Interna Medicine, General Hospital dr. Zainoel Abidin, Banda Aceh, Aceh, 23111, Indonesia
(4) Gastroenterohepatology Division, Department of Internal Medicine, Faculty of Medicine, Syiah Kuala University, Banda Aceh, Aceh, 23111, Indonesia / Gastroenterohepatology Division, Departemen of Interna Medicine, General Hospital dr. Zainoel Abidin, Banda Aceh, Aceh, 23111, Indonesia
(5) Endocrin, Metabolic and Diabetes Division, Departemen of Interna Medicine, General Hospital dr. Zainoel Abidin, Banda Aceh, Aceh, 23111, Indonesia
(6) School of Medicine, Department of Internal Medicine, Syiah Kuala University, Banda Aceh, Aceh, 23111, Indonesia
(7) Department of Medicine, National University of Singapore, Singapore
Corresponding Author

Abstract


Acute pancreatitis is a frequent disorder whose severity level varies from mild to life-threatening. This condition is characterized by abrupt inflammation of the pancreas. A 53-year-old male was having upper right abdominal pain and epigastric pain which began four hours after hospitalization. This case highlights the complexities of managing acute pancreatitis in a patient with Graves' disease, where hyperthyroidism may worsen pancreatitis and vice versa. Graves' disease is an autoimmune disorder causing hyperthyroidism, which can complicate pancreatitis management, particularly when treated with methimazole, which has been associated with acute pancreatitis. This case suggests a potential link between untreated Graves' disease and idiopathic acute pancreatitis. In patients presenting with unexplained pancreatitis, evaluation for hyperthyroidism may be warranted. The novelty of this case lies in the exclusion of all conventional etiologies and the possible role of autoimmune thyroid disease in pancreatic inflammation.

Keywords


Acute pancreatitis, graves’ disease, hyperthyroidism

References


Khandelwal A, Inoue D, Takahashi N. Autoimmune pancreatitis: an update. Abdom Radiol (NY). 2020 May;45(5):1359-70.

Zilio MB, Eyff TF, Azeredo-Da-Silva ALF, Bersch VP, Osvaldt AB. A systematic review and meta-analysis of the aetiology of acute pancreatitis. HPB (Oxford) [Internet]. 2019 Mar 1 [cited 2025 Jul 16];21(3):259-67. Available from: https://www.researchgate.net/publication/327818552_A_systematic_review_and_meta-analysis_of_the_aetiology_of_acute_pancreatitis

Mederos MA, Reber HA, Girgis MD. Acute pancreatitis: a review. JAMA [Internet]. 2021 Jan 26 [cited 2025 Jul 16];325(4):382-90. Available from: https://pubmed.ncbi.nlm.nih.gov/33496779/

Valverde-López F, Wilcox CM, Redondo-Cerezo E. Evaluation and management of acute pancreatitis in Spain. Gastroenterol Hepatol [Internet]. 2018 Dec 1 [cited 2025 Jul 16];41(10):618-28. Available from: https://pubmed.ncbi.nlm.nih.gov/30149943/

Agito K, Manni A. Acute pancreatitis induced by methimazole in a patient with subclinical hyperthyroidism. J Investig Med High Impact Case Rep [Internet]. 2015 May 19 [cited 2025 Jul 16];3(2). Available from: https://pubmed.ncbi.nlm.nih.gov/26425645/

Brix TH, Lund LC, Henriksen DP, Folkestad L, Bonnema SJ, Hallas J, et al. Methimazole and risk of acute pancreatitis. Lancet Diabetes Endocrinol [Internet]. 2020 Mar 1 [cited 2025 Jul 16];8(3):187-9. Available from: https://pubmed.ncbi.nlm.nih.gov/32035032/

Talathi SS, Zimmerman R, Young M. Anatomy, abdomen and pelvis, pancreas. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Apr 5 [cited 2025 Jul 16]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532912/

Davies TF, Andersen S, Latif R, Nagayama Y, Barbesino G, Brito M, et al. Graves’ disease. Nat Rev Dis Primers [Internet]. 2020 Dec 1 [cited 2025 Jul 16];6(1). Available from: https://pubmed.ncbi.nlm.nih.gov/32616746/

de-Madaria E, Buxbaum JL, Maisonneuve P, García García de Paredes A, Zapater P, Guilabert L, et al. Aggressive or moderate fluid resuscitation in acute pancreatitis. N Engl J Med. 2022 Sep 15;387(11):989-1000.

Barrie J, Jamdar S, Smith N, McPherson SJ, Siriwardena AK, O’Reilly DA. Misuse of antibiotics in acute pancreatitis: insights from the United Kingdom’s National Confidential Enquiry into patient outcome and death (NCEPOD) survey. Pancreatology. 2018 Oct;18(7):721-6.

Pecere A, Caputo M, Sarro A, Ucciero A, Zibetti A, Aimaretti G, et al. Methimazole treatment and risk of acute pancreatitis: a population-based cohort study. J Clin Endocrinol Metab [Internet]. 2020 Dec 1 [cited 2025 Jul 16];105(12). Available from: https://www.thyroid.org/patient-thyroid-information/ct-for-patients/july-2021/vol-14-issue-7-p-5-6/

Chng CL, Kek PC, Khoo DHC. Carbimazole-induced acute pancreatitis and cholestatic hepatitis. Endocr Pract [Internet]. 2011 Nov [cited 2025 Jul 16];17(6):960-1. Available from: https://www.researchgate.net/publication/351268475_Carbimazole-Induced_Acute_Pancreatitis_and_Cholestatic_Hepatitis

Liu Y, Lou X. The occurrence of acute pancreatitis after iodine 131 treatment of hyperthyroidism. Acta Endocrinol (Buchar) [Internet]. 2022 Apr 1 [cited 2025 Jul 16];18(2):250. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9512377/

Antonelli A, Fallahi P, Elia G, Ragusa F, Paparo SR, Ferrari SM. Graves’ disease: clinical manifestations, immune pathogenesis (cytokines and chemokines) and therapy. Best Pract Res Clin Endocrinol Metab. 2020;34(1):101388. doi:10.1016/j.beem.2020.101388

Kahaly GJ, Bartalena L, Hegedüs L, Leenhardt L, Poppe K, Pearce SH. 2018 European Thyroid Association guideline for the management of Graves’ hyperthyroidism. Eur Thyroid J. 2018;7(4):167-86. doi:10.1159/000490384


Full Text: PDF

Article Metrics

Abstract View : 140 times
PDF Download : 101 times

DOI: 10.24871/2622025195-200

Refbacks

  • There are currently no refbacks.