Acute pancreatitis – An immune mediated injury of rheumatic fever

Acute pancreatitis is an acute inflammatory disease of the pancreas that may also involve surrounding tissues since the pancreas lacks a capsule, the pancreatic enzymes access to adjacent area and digest the fascial layers. It is observed as an initial manifestation of group A beta hemolytic streptococcal infection in a 32 years young, obese male in this tropical region where Rheumatic fever is endemic. He was admitted with acute abdominal pain and supported with intravenous fluids and pain not relieved by any medications and blood analysis showed an elevated amylase and lipase levels, raised ESR and a positive ASO titer and CT abdomen revealed interstitial edematous pancreatitis (IEP). Patient was treated with intravenous antibiotics and the pain subsided immediately and blood parameters returned to normal levels at 4 weeks and follow up CT revealed no abnormal findings and symptom free thereafter.