A rare case of acute pancreatitis with kidney disease in a Gambian child

Abstract

Background: Acute pancreatitis (AP) with severe acute kidney injury (AKI) is rare in children and is associated with high morbidity and mortality rates. Pancreatitis and kidney disease are complex combinations. Severe acute pancreatitis associated with multiorgan failure (respiratory, cardiovascular, and kidney) may occur in about 20% of patients with acute pancreatitis.

Case Report: We report the rare case of a 12-year-old boy who presented with acute pancreatitis and acute kidney injury at the Department of Paediatrics, Edward Francis Small Teaching Hospital (EFSTH). He presented with a week's history of loss of appetite, four days of abdominal pain, vomiting, fever and nonpassage of urine of 2 days duration. He was seen in a private clinic before presenting to EFSTH, where he came with AKI and had a pancreatic cyst on ultrasound. He was given intravenous fluids, antibiotics (IV Ciprofloxacin, Meropenem) and had haemodialysis (HD) for 23 sessions until renal function improved. He was discharged on outpatient follow-up with regular monitoring of pancreatic enzymes (serum amylase, lipase) and kidney function. He currently has a reduction in his estimated glomerular filtration rate at 34.0ml / min / 2 1.73m, with occasional relapse of pancreatitis, and is being managed for chronic kidney disease, stage 3.

Conclusion: This case highlights the poor outcome of the rare case of acute pancreatitis complicated by acute kidney disease, which progressed to chronic kidney disease despite prompt treatment and initiation of kidney replacement therapy.