Arizona College of Osteopathic Medicine Glendale, AZ
Manasa Sagaram, DO1, Preeyanka Sundar, MD2, Sudhakar Reddy, MD2; 1Arizona College of Osteopathic Medicine, Glendale, AZ; 2Mountain Vista Medical Center, Mesa, AZ
Introduction: Acute pancreatitis (AP) is a leading gastrointestinal cause of hospitalization in the United States, and 20% of AP is considered idiopathic. Cannabis has now become the most commonly used illicit drug with increasing prevalence as well as legalization. Cannabis has been reported in several case reports as a possible etiology of idiopathic AP. The aim of this critical analysis is to systematically review the literature and analyze cannabis as an etiology of idiopathic and recurrent AP. Another aim is to identify any risk factors or demographics associated with this population and a correlation with the severity of AP. Methods: Case reports with cannabis induced acute pancreatitis, as well as retrospective and prospective reviews, were identified systematically through a detailed PubMed search. For each case report, the Naranjo Adverse Drug Reaction (ADR) score as well as severity of the pancreatitis were calculated, the latter with scores such as modified CT severity index (CTSI) and revised Atlanta classification (RAC) among others. Results: Eighteen case reports were included along two large studies. Fourteen of the cases (77.78%), 87.5% (Culetto et al) and 71.7% (Simons-Linares et al) of the study patients were male. Fourteen of the cases (77.78%), and 80% (Culetto et al, Simons-Linares et al) of the study patients were under the age of 35. Eight of the cases (44.44%) and 100% (Simons-Linares et al) of study patients had recurrent cannabis induced acute pancreatitis. None of the patients who were followed up with experienced recurrent pancreatitis after stopping cannabis use. In the cases, as severity worsened using both CTSI and RAC scores, the proportion of males increased from 76.92% to 100% and from 71.43% to 100% respectively. There was also an increase in proportion of patients under 35 years with increase in severity, from 69.23% to 100% and from 71.43% to 100% respectively. Discussion: This study demonstrates a higher proportion of cannabis induced pancreatitis cases were males. In addition, there was an increase in the proportion of males and proportion of patients under 35 years with an increase in severity. In all followup cases, no patients had recurrent pancreatitis after stopping cannabis. Since widespread cannabis use is becoming steadily more prevalent, especially in a younger population, and may be an etiology in idiopathic acute pancreatitis, cannabis use should be documented in acute pancreatitis for future analysis and any new treatment
Disclosures: Manasa Sagaram indicated no relevant financial relationships. Preeyanka Sundar indicated no relevant financial relationships. Sudhakar Reddy indicated no relevant financial relationships.