Thiopurine-induced pancreatitis

Thiopurine- induced pancreatitis  (TIP) coming under the umbrella PRED4 

• History of inflammatory bowel disease
• Acute severe abdominal pain
• History of thiopurine exposure in the previous 7 days
• Rise in serum pancreatic enzymes (amylase/lipase) (>2 times upper limit of normal)
• Episode of acute pancreatitis within 3 months of starting thiopurine
• Medical opinion implicates thiopurine as the most likely cause of pancreatitis, and drug withdrawn

Tips which we have found helpful to identify patients:

 Generate a list of IBD patients from your database or by asking IT to search using ICD10 codes UC (K51) and CD (K50)
Give your Biochemistry department the list of hospital numbers of IBD patients and/or ask them to search for all patients who have ever had an Amylase >2x ULN (referred by Gastroenterologists)
 Combine for Ulcerative Colitis (K51) + Y40-Y59 (Drugs, medicaments and biological substances causing adverse effects)
Or Combine for Crohn’s disease (K50) + Y40-Y59 (Drugs, medicaments and biological substances causing adverse effects)
 Cross reference against Ulcerative Colitis (K51) and Crohn’s Disease (K50): K85.0 (Idiopathic acute pancreatitis),
K85.3 (Drug-induced pancreatitis), K85.8 (Other acute pancreatitis) and K85.9 (Acute pancreatitis, unspecified)

The latest CRF is below

IBD TIP CRF v3