Reactions 747 - 17 Apr 1999

★Riluzole

First report of pancreatitis in an elderly patient:case report

A 77-year-old woman developed pancreatitis duringtreatment with riluzole for amyotrophic lateral sclerosis.

Six months after starting treatment with riluzole 50mg twicedaily, the woman was hospitalised with low-grade fever,severe abdominal pain and vomiting. Her abdomen was tenderon examination. Her blood amylase level was increased to8430 U/ml (normal 15–120) and she had borderlineleucocytosis and mild anaemia.

Riluzole was discontinued and the woman was treated withampicillin, gentamicin and metronidazole. Her conditionimproved and her blood amylase level decreased to 254 U/mlwithin 3 days. However, she experienced similar symptomstwice during the following month. An abdominal ultrasoundrevealed an oedematous pancreas head, without evidence ofbiliary duct obstruction. Although the woman recovered frompancreatitis, she later died from her primary disease.

Author comment: ‘The only drug that was begun recentlyand discontinued following pancreatitis was riluzole, makingthe relationship likely . . . Until December 1997, 10 cases ofpancreatitis possibly related to riluzole were reported to Rhone-Poulenc-Rorer, resulting in an incidence of about 4.5/10,000treated patients. In all but one patient, the disorder wasreversible after discontinuing the drug.’Drory VE, et al. Riluzole-induced pancreatitis. Neurology 52: 892-893, 10 Mar1999 - Israel 800751353

» Editorial comment: A search of AdisBase and Medline didnot reveal any previously published case reports of pancreatitisassociated with riluzole.

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Reactions 17 Apr 1999 No. 7470114-9954/10/0747-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved