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array:19 [ "pii" => "S0210570509003677" "issn" => "02105705" "doi" => "10.1016/j.gastrohep.2009.03.003" "estado" => "S300" "fechaPublicacion" => "2009-10-01" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Gastroenterol Hepatol. 2009;32:588-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 10110 "formatos" => array:3 [ "EPUB" => 12 "HTML" => 9463 "PDF" => 635 ] ] "itemAnterior" => array:16 [ "pii" => "S0210570509003653" "issn" => "02105705" "doi" => "10.1016/j.gastrohep.2009.03.002" "estado" => "S300" "fechaPublicacion" => "2009-10-01" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Gastroenterol Hepatol. 2009;32:587-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2884 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 2540 "PDF" => 338 ] ] "es" => array:9 [ "idiomaDefecto" => true "titulo" => "Meningitis por <span class="elsevierStyleItalic">Listeria monocytogenes</span> durante tratamiento con adalimumab" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "587" "paginaFinal" => "588" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Meningitis due to <span class="elsevierStyleItalic">Listeria monocytogenes</span> during adalimumab therapy" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Cecilia Gil, Jesús Legido, Carlos Cuenca, Ana Santamaría, María Victoria Sacristán, Concepción Salvatierra, Eugenio Fernández-Rubio, Julio Izquierdo" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Cecilia" "apellidos" => "Gil" ] 1 => array:2 [ "nombre" => "Jesús" "apellidos" => "Legido" ] 2 => array:2 [ "nombre" => "Carlos" "apellidos" => "Cuenca" ] 3 => array:2 [ "nombre" => "Ana" "apellidos" => "Santamaría" ] 4 => array:2 [ "nombre" => "María Victoria" "apellidos" => "Sacristán" ] 5 => array:2 [ "nombre" => "Concepción" "apellidos" => "Salvatierra" ] 6 => array:2 [ "nombre" => "Eugenio" "apellidos" => "Fernández-Rubio" ] 7 => array:2 [ "nombre" => "Julio" "apellidos" => "Izquierdo" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210570509003653?idApp=UINPBA00004N" "url" => "/02105705/0000003200000008/v0_201307171023/S0210570509003653/v0_201307171025/es/main.assets" ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Cocaine induced acute pancreatitis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "588" "paginaFinal" => "589" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Sergio Vázquez-Rodríguez, Santiago Soto, Estela Fernández, Ruth Baltar, Enrique Vázquez-Astray" "autores" => array:5 [ 0 => array:3 [ "nombre" => "Sergio" "apellidos" => "Vázquez-Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:4 [ "nombre" => "Santiago" "apellidos" => "Soto" "email" => array:1 [ 0 => "iagosoto@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 2 => array:3 [ "nombre" => "Estela" "apellidos" => "Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 3 => array:3 [ "nombre" => "Ruth" "apellidos" => "Baltar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 4 => array:3 [ "nombre" => "Enrique" "apellidos" => "Vázquez-Astray" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicio de Aparato Digestivo, Complexo Hospitalario de Pontevedra" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "correspondencia" => "Autor para correspondencia. iagosoto@hotmail.com" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pancreatitis aguda inducida por cocaína" ] ] "textoCompleto" => "<p class="elsevierStylePara">Cocaine (benzoylmethyl ecgonine) is a crystalline tropane alkaloid that is obtained from the leaves of the coca. Cocaine is an addictive illegal drug<a href="#bib1" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a>. Spain has become the top consumer of cocaine in continental Europe, according to a recent European Union study on drug use. By a United Nations count, 3% of Spain's adult population consumes cocaine. Specifically, it is a dopamine reuptake inhibitor, a norepinephrine reuptake inhibitor and a serotonin reuptake inhibitor<a href="#bib2" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a>. Cocaine is a potent central nervous system stimulant. Short-term cocaine effects include: increased blood pressure, constricted blood vessels, mental alertness, dilated pupils, increased energy, increased heart rate and temperature and decreased appetite<a href="#bib3" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">,</span><a href="#bib4" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">4</span></a>.</p><p class="elsevierStylePara">Cardiovascular and neurologic are the predominant alterations. Digestive complications are infrequent. Pancreatic involvement is exceptional and only isolated cases have been reported<a href="#bib2" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">,</span><a href="#bib5" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">5</span></a>.</p><p class="elsevierStylePara">A 21 years old boy with epilepsy treated with lamotrigine was accepted at hospital with abdominal pain radiated straight through to the back, nausea and vomiting. Amylase reached 1710U/L, lipase 2981U/L, LDH 2399U/L, Hematocrit 50,2%, white blood cell count was 21300/mm<span class="elsevierStyleSup">3</span> (77,4% neutrophils) platelets 416.000/mm<span class="elsevierStyleSup">3</span>. Blood urea, oxygen saturation, serum calcium, coagulation parameters and triglyceride levels were normal. The patient denied alcohol ingestion or drugs consumption. Serological studies for CMV, EBV and HIV were negative. Abdominal ultrasonography excluded gallstones and dilatation of the bile duct. A spiral computed tomography with contrast performed within 48 hours showed diffuse enlargement of the pancreas with minimal ascites (Grade B of Balthazar). Cholangiography MRI was normal. Because of these results USE and ERCP were not performed.</p><p class="elsevierStylePara">Urine drugs test was positive for cocaine and the patient admitted to use insufflated cocaine as a recreational drug. He had taken cocaine 48hours before abdominal pain started. Alcohol consumption was ruled out.</p><p class="elsevierStylePara">Clinical evolution was positive without complications and the patient was discharged within 6 days. After hospitalization, he has been controlled every three months during two years without new events.</p><p class="elsevierStylePara">Cocaine consumption seems to be the cause of acute pancreatitis in this patient. The absence of other recognized etologies, the antecedent of insufflated cocaine consumption in the last 48 hours and the elevated LDH serum values made cocaine to be the cause of acute pancreatitis in this young patient.</p><p class="elsevierStylePara">Cocaine consumption cause several medical problems<a href="#bib6" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">6</span></a>. Heart attack, arrhythmias, stroke and convulsions are the most frequent. Psychiatric, pulmonary and renal complications have been described. Digestive complications are infrequent. Intestinal ischemia<a href="#bib9" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">9</span></a><span class="elsevierStyleSup">,</span><a href="#bib10" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">10</span></a>, perforation<a href="#bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">7</span></a>, retroperitoneal fibrosis, gastric ulcer<a href="#bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">8</span></a> has been described. Pancreatic involvement is exceptional and only very few cases have been reported.</p><p class="elsevierStylePara">Most of acute pancreatitis are related with alcohol consumption or gallstones. Pancreatic ischemia causes acute pancreatitis too.</p><p class="elsevierStylePara">Cocaine blocks the presynaptic reuptake of the neutotransmitters norepinephrine and dopamine. It also causes monoaminooxidases inhibition and it has a direct anticholinergic action. This way alpha- adrenergic receptors are highly stimulated. Activation of the sympathetic nervous system by this mechanism produces vasoconstriction and ischemia<a href="#bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">8</span></a>.</p><p class="elsevierStylePara">Autor para correspondencia. iagosoto@hotmail.com</p>" "pdfFichero" => "14v32n08a13141355pdf001.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Medical complications of cocaine abuse." 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