Large doses of cortisone administered to rabbits X produce pathologic changes in pancreatic acini, focal necrosis, and lesions characteristic of focal pancreatitis. To date, few cases of pancreatitis in patients receiving corticotropin or adrenal steroids have been reported. Six patients in whom acute pancreatitis was apparently induced by steroid therapy are reported by Nelp in a recent issue of the Archives of Internal Medicine.1 These patients were admitted to Johns Hopkins Hospital in the course of 2 1/2 years. During the same period approximately 60 patients with an initial attack of acute pancreatitis were admitted.
Analysis of the cases reveals that in only 1 was acute pancreatitis diagnosed initially. The diagnoses in the remaining 5 were steroid-induced peptic ulcer in 2, and perforated viscus, cholecytitis, and abdominal lymphoma, 1 each. The correct diagnosis of pancreatitis was made during surgical intervention in 3 patients and at autopsies in the 2