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Pancreatic enlargement in a patient receiving therapy with vasodilators for pulmonary arterial hypertension: a case report

Abstract

Epoprostenol is a prostacyclin (prostaglandin I2) analog that causes vasodilation and inhibits platelet aggregation and is used in the management of severe pulmonary arterial hypertension (PAH). We herein report a patient with PAH who developed pancreatic enlargement after the initiation of therapy including epoprostenol. Although it is well known that thyroid enlargement occurs in patients with PAH receiving epoprostenol therapy, the pancreatic findings associated with epoprostenol therapy have not been well described. Although the size of the pancreas was clearly increased, there was no blood data or symptoms suggestive of abnormal pancreatic function and pancreatitis, and the patient’s abdominal complaints improved quickly, despite the continuation of epoprostenol therapy. Eleven months after the start of continuous intravenous epoprostenol infusion therapy, the pancreatic enlargement was still evident on imaging, but there were no abdominal symptoms or elevated pancreatic enzymes. This case highlights the fact that epoprostenol therapy may cause pancreatic changes that mimic acute or autoimmune pancreatitis.

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Acknowledgements

We thank Kelly Zammit, BVSc, from Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Correspondence to Yuko Someya.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Written informed consent was waived in this case report in accordance with the opt-out method used at our institution.

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Someya, Y., Koyasu, S., Ohnishi, Y. et al. Pancreatic enlargement in a patient receiving therapy with vasodilators for pulmonary arterial hypertension: a case report. Abdom Radiol 47, 1948–1953 (2022). https://doi.org/10.1007/s00261-022-03458-9

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  • DOI: https://doi.org/10.1007/s00261-022-03458-9

Keywords

  • Pulmonary arterial hypertension
  • Continuous intravenous prostacyclin analog infusion therapy
  • Epoprostenol
  • Pancreatic enlargement