Acute pancreatitis following lisinopril rechallenge

Acute pancreatitis has many causes, the most common being biliary tract disease and alcoholism, Other etiologic categories are abdominal trauma; postoperative, including endoscopic retrograde cholangiopancreatography; metabolic, Including hypercalcemia and hypertriglyceridemia; infectious; idiopathic; and drug induced. The drugs most strongly associated with pancreatitis are sulfonamides, thiazides, furosemide, estrogens, and tetracycline, Approximately 100 cases of pancreatitis induced by angiotensin converting enzyme inhibitor have been reported to the US Food and Drug Administration, of which about 20 involved lisinopril. We report a case of pancreatitis occurring only 3 hours after intake of lisinopril by a man without other risk factors for the illness. The patient had experienced a similar but less severe reaction to this medication 3 months earlier. This case probably represents the first time a patient was rechallenged with lisinopril and had a more significant adverse reaction. Copyright (C) 1998 by W.B. Saunders Company.