Acute Pancreatitis Secondary to Doxycycline, a Widely Prescribed Antibiotic: A Case Report

Acute pancreatitis is a leading cause of hospital admissions in the United States. Although drug-induced acute pancreatitis is considered rare, it is an important etiology to consider. We report a case of acute pancreatitis potentially due to doxycycline. A 59-year-old woman with a history of breast cancer, undergoing chemotherapy with palbociclib and fulvestrant for the last two years, was admitted for severe epigastric pain radiating to the back. Six days earlier, she had started doxycycline for an upper respiratory infection. Serum lipase was 837 U/L, a computed tomography scan showed diffuse acute pancreatitis without necrosis, and common etiologies such as gallstones, alcohol use, and metabolic disorders were excluded. On admission, doxycycline was discontinued, and the patient reported significant improvement in symptoms with supportive care within four days. Because of the temporal association and exclusion of other causes, doxycycline was identified as the most likely etiology. By presenting this case, we want to highlight the importance of considering doxycycline as a potential cause of acute pancreatitis and underscore the need for heightened doxycycline pharmacovigilance to improve patient safety.