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Continuous regional arterial infusion effective for children with acute necrotizing pancreatitis even under neutropenia.

Abstract
Severe acute pancreatitis is one of the critical conditions that may develop in children with cancer. The leading cause of death due to acute pancreatitis is infectious pancreatitis or circulation collapse. Therefore, patients who develop acute pancreatitis while undergoing chemotherapy or after hematopoietic transplantation are at risk for a life-threatening and fatal course. We treated 140 patients with malignancy from April 2002 to March 2009 at our hospital and encountered 3 patients under neutropenia who developed severe acute pancreatitis. Two of them were successfully treated with continuous regional arterial infusion of a protease inhibitor and antibiotic even under agranulocytosis. Another patient was treated with conventional therapy with intravenous antibiotics plus a protease inhibitor and total or partial parenteral nutrition. Even though the two patients treated with continuous regional arterial infusion presented much more severe conditions, their symptoms resolved earlier. In conclusion, acute pancreatitis is one of the severe complications of childhood malignancy. Even under agranulocytosis, continuous regional arterial infusion of a protease inhibitor and antibiotic was well tolerated and effective among our cases and might reduce early death due to pancreatitis.
AuthorsHiroko Fukushima, Takashi Fukushima, Ryoko Suzuki, Takashi Enokizono, Maki Matsunaga, Tomohei Nakao, Kazutoshi Koike, Kensaku Mori, Kiyoshi Matsueda, Ryo Sumazaki
JournalPediatrics international : official journal of the Japan Pediatric Society (Pediatr Int) Vol. 55 Issue 2 Pg. e11-3 (Apr 2013) ISSN: 1442-200X [Electronic] Australia
PMID23679174 (Publication Type: Case Reports, Journal Article)
Copyright© 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.
Chemical References
  • Anti-Bacterial Agents
  • Protease Inhibitors
Topics
  • Adolescent
  • Anti-Bacterial Agents (administration & dosage)
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infusions, Intra-Arterial
  • Male
  • Neutropenia (drug therapy, etiology)
  • Pancreatitis, Acute Necrotizing (complications, drug therapy)
  • Protease Inhibitors (administration & dosage)

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