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Was It Pancreatitis?

Kenneth A. Hubel, MD
JAMA. 1966;195(3):229. doi:10.1001/jama.1966.03100030123045.
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To the Editor:—  The role of adrenal steroid treatment as a cause of pancreatitis was reported by Schrier and Bulger ("Steroid-Induced Pancreatitis," 194:564, 1965). The diagnosis of pancreatitis was supported by only two findings: (1) "Epigastric and right-upper-quadrant pain which radiated to the back," and (2) One serum amylase determination measuring 284 units/100 cc. Penetrating peptic ulcer as a cause of the hyperamylasemia was excluded by the normal gastrointestinal x-ray films and a lack of symptomatic response to antacids.Notably absent was a report of the abdominal findings at the time of the pain. In a case in which all the findings relative to the "pancreatitis" could be explained by disease of the biliary tree, no radiographic or chemical studies of biliary function are recorded. There was insufficient evidence to justify a diagnosis of pancreatitis.There was little reason to attribute the elevated serum amylase to prednisone rather than


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