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Rare case of pancrelipase therapy-induced neutropaenia
  1. Richard Amoateng1,
  2. Brent Hardman1,
  3. Catherine Liu2 and
  4. Scarlett Austin1
  1. 1Internal Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
  2. 2School Of Medicine, Drexel University, Philidelphia, Pennsylvania, USA
  1. Correspondence to Dr Richard Amoateng; reipkter447{at}


A 61-year-old man was transferred to our facility from an outside hospital due to refractory neutropaenia of unknown aetiology. The patient presented to the referring hospital with a 5-day history of worsening diarrhoea and abdominal pain. Initial lab results at presentation showed severe neutropaenia with an absolute neutrophil count of 0. Investigations included a bone marrow biopsy which showed slightly hypocellular marrow with near absence of granulocytic precursors. A CT without contrast showed evidence of chronic pancreatitis and acute colitis. The patient’s neutropaenia persisted despite granulocyte colony-stimulating factor therapy. The patient was, thus, transferred to our facility for a higher level of care. At our facility, the patient had rapid correction of neutropaenia after discontinuation of pancrelipase therapy. The patient’s abdominal pain and diarrhoea also improved while off pancrelipase. Neutropaenia has completely resolved 6 weeks after discharge without any further therapy.

  • drug interactions
  • haematology (drugs and medicines)
  • drugs: gastrointestinal system
  • ulcerative colitis
  • pancreatitis

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  • Contributors RA is the main author of this case report. RA did most of the groundwork, reviewing articles for referencing and discussion. RA wrote the initial draft, formatted figures, constructed figure 4, and completed the final draft and edits of the case report. RA also coordinated with the patient and was the main person that communicated with the patient. RA was also solely responsible for revisions for re-submission. BH acted as the supervisor for this case report. He helped with the final draft and edits. He also helped with the formatting and style. CL helped extract patient’s data from electronic medical records. She also identified suitable articles to be included in the discussion. She also constructed figures 1–3. SA contributed by editing and fixing grammatical errors. She also contributed to the formatting of the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer None

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.