Clinical case of acute pancreatitis associated with COVID-19 vaccination

Authors: N. B. Gubergrits1, Yu. M. Alkhazov2, N. A. Abdullaeva3

1 Into Sana” Multifield Clinic, Odessa, Ukraine
2 Euromed” Clinic, Baku, Azerbaijan
3 Azerbaijan National Academy of Sciences (ANAS ), Baku, Azerbaijan

The onset of acute pancreatitis after vaccination against COVID-19 is extremely rare. Three clinical cases of acute pancreatitis after vaccination have been described (Pfizer-BioNTech COVID-19 mRNA vaccine in all cases).

Patient B., 38 years old, a programmer, considered himself healthy (mentioned only rare colds). Aching pain appeared in the left side of the lower back (not related to physical activity, bending or eating) a day after the second injection of Pfizer-BioNTech COVID-19 mRNA vaccine. He noticed a decrease in appetite, general weakness, nausea, loose stools, bloating, and subfebrile temperature. Blood α-amylase was increased by 28.8 times, urine by 6.7 times. Glycemia, glycosylated hemoglobin were normal. The diagnosis of acute pancreatitis was confirmed by the results of computed tomography and endoscopic sonography. Alcoholic, biliary, and autoimmune etiology of the disease were excluded.

Clinical diagnosis: Acute pancreatitis, mild course. Severe exocrine pancreatic insufficiency. Chronic non-atrophic Helicobacter pylori-associated active gastritis, OLGA grade — 0.

The patient’s condition improved after infusion and antisecretory therapy; blood and urine pancreatic enzymes, C-reactive protein normalized. Since low fecal elastase persists, the patient is administered Creon.

The patient is being monitored. In a month, we are going to conduct control of fecal elastase-1, computed tomography, and endosonography if necessary. Blood and urine pancreatic enzymes, glycemia will be monitored every two weeks for two months, then once a month. Anti-Helicobacter pylori therapy is postponed until the patient fully recovers from acute pancreatitis (approximately six months).

Key words: COVID-19, vaccination, acute pancreatitis, clinical case, diagnosis

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