Drug-Induced Pancreatitis — RACP Adult Medicine MCQ

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ModerateGastroenterologyDrug-Induced PancreatitisRACP Adult Medicine

A 35-year-old woman presents with acute pancreatitis. She has no gallstones and no alcohol use. Triglycerides are normal. She was started on azathioprine for Crohn disease 6 weeks ago. What is the most likely aetiology?

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Correct answer: B — Drug-induced pancreatitis

Acute pancreatitis occurring 2-8 weeks after azathioprine initiation, without gallstones, alcohol, or hypertriglyceridaemia, is drug-induced pancreatitis. Azathioprine causes pancreatitis in 3-5% of patients. It is an idiosyncratic (dose-independent) reaction. The drug must be ceased and never re-challenged. Other common drug causes: sodium valproate, GLP-1 agonists, thiazides, mesalazine, and didanosine.

Reference: AMH – 2025 – Azathioprine; GESA 2024 – Drug-Induced Pancreatitis