Propofol as a Cause of Recurrent Pancreatitis in A Child with ESRD; A Cautionary Tale

Excerpt

To the Editor: An 8-y-old girl with end stage renal disease (ESRD) secondary to focal segmental glomerulosclerosis had been on chronic peritoneal dialysis (PD) since age of 2 y. She had altered lipid profile owing to her native renal disease. She had 2 episodes of refractory bacterial peritonitis at age of 4 and 7.5 y respectively warranting the catheter removal under general anesthesia (GA). Both episodes were followed immediately by clinical and laboratory proven acute pancreatitis (AP) which were managed conservatively and uneventfully. Imaging studies were normal. The work up for AP was normal. A review of medications received during anesthesia was done and Propofol had been used as an induction agent in both episodes. Propofol is known to precipitate AP in patients with underlying hypertriglyceridemia (as in our index case) and it was decided to avoid Propofol for any forthcoming surgeries such as transplant etc. …