Sex: M
Vaccine: COVID19
Symptoms: Blood alkaline phosphatase, Blood bicarbonate, Blood bilirubin, Blood calcium, Blood chloride
Clinical narrative: Acute pancreatitis; The initial case was missing the following minimum criteria: (unspecified suspect product). Upon receipt of follow-up information on (03Nov2022), this case now contains all required information to be considered valid.  This is a literature report.  An 82-year-old male patient received BNT162b2 (BNT162B2), as dose 3 (booster), single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "coronary artery disease" (unspecified if ongoing); "prostate cancer" (unspecified if ongoing), notes: in remission, treated with radiation therapy; "gastroesophageal reflux disease" (unspecified if ongoing), notes: for about 50 years; "hypothyroidism" (unspecified if ongoing); "stent placed" (unspecified if ongoing), notes: about 30 months ago; "radiation proctocolitis" (unspecified if ongoing); "partial colectomy" (unspecified if ongoing), notes: with end anastomosis about 20 years ago; "hypothyroidism" (unspecified if ongoing), notes: For about 36 years; "no smoking" (unspecified if ongoing); "no recreational drug use" (unspecified if ongoing); "consumption of alcoholic beverages" (unspecified if ongoing). Concomitant medication(s) included: ASPIRIN SODIUM; ATORVASTATIN taken for coronary artery disease; MESALAMINE taken for colitis; PANTOPRAZOLE taken for gastrooesophageal reflux disease; LEVOTHYROXINE taken for hypothyroidism. Vaccination history included: Bnt162b2 (Dose number unspecified), for COVID-19 immunisation, reaction(s): "mild headache", "myalgia". The following information was reported: PANCREATITIS ACUTE (hospitalization, medically significant), outcome "recovering", described as "Acute pancreatitis". The patient was hospitalized for pancreatitis acute (hospitalization duration: 2 day(s)). The patient underwent the following laboratory tests and procedures: Abdomen scan: which revealed a soft abdomen, mild epigastric, notes: tenderness, without rebound or gaurding; Alanine aminotransferase (7-52): 12 IU/l, notes: At presentation; Anion gap (3-11): 10 mmol/L, notes: At presentation; Aspartate aminotransferase (13-39): 14 IU/l, notes: At presentation; Blood albumin (3.5-5.7): 4.2 g/dl, notes: At presentation; Blood alkaline phosphatase (34-104): 42 IU/l, notes: At presentation; Blood bicarbonate (23.0-29.0): 25.5 mmol/L, notes: At presentation; Blood bilirubin (0.3-1.0): 0.8 mg/dl, notes: At presentation; Blood calcium (8.6-10.3): 9.3 mg/dl, notes: At presentation; Blood chloride (98-107): 103 mmol/L, notes: At presentation; Blood cholesterol (normal high range 200): 115 mg/dl, notes: At presentation; Blood creatinine (0.7-1.3): 1.2 mg/dl, notes: At presentation; Blood ethanol: Less than 10, notes: At presentation; Blood glucose (70-105): 129 mg/dl, notes: At presentation; Blood lactic acid (0.5-2.2): 1.1 mmol/L, notes: At presentation; Blood magnesium (1.5-2.5): 2.1 mg/dl, notes: At presentation; Blood phosphorus (2.5-5.0): 2.1 mg/dl, notes: At presentation; Blood potassium (3.5-5.1): 3.2 mmol/L, notes: At presentation; Blood sodium (136-145): 138 mmol/L, notes: At presentation; Blood triglycerides (normal high range 150): 57 mg/dl, notes: At presentation; Blood urea (7-25): 23 mg/dl, notes: At presentation; Brain natriuretic peptide (1.0-100.0): 41.0 pg/mL, notes: At presentation; Computerised tomogram abdomen: showed moderate peripancreatic fat stranding with, notes: tracking fluid into the mesenteric root, suggestive for acute interstitial pancreatitis, without evidence of necrosis; Of note, no calcified cholelithiasis, gallbladder, notes: wall thickening, or biliary dilatation was observed (Figure 1); Drug screen: Negative, notes: At presentation; Haematocrit (42.0-54): 46.9 %, notes: At presentation; Haemoglobin (14.0-18.0): 16.6 g/dl, notes: At presentation; High density lipoprotein (23-92): 44 mg/dl, notes: At presentation; Lipase (11-82): 2257 IU/l, notes: At presentation elevated; 268 IU/l, notes: decreased at his discharge; Low density lipoprotein: 60 mg/dl, notes: At presentation; On examination: his vital signs were stable; was unremarkable; Platelet count (150-450): 156 cells/uL, notes: At presentation Unit: 1000 cells/uL; Red blood cell sedimentation rate (0-20): 23, notes: At presentation, Units: mm/h; Troponin I (normal high range 0.025): 0.021 ng/ml, notes: At presentation; Ultrasound scan: showed normal gall bladder without evidence of, notes: cholelithiasis and a normal common duct measuring 5 mm; White blood cell count (3.8-10.8): 9.3 cells/uL, notes: At presentation Unit: 1000 cells/uL. Therapeutic measures were taken as a result of pancreatitis acute.; Sender's Comments: As there is limited information in the case provided, the causal association between the event Acute pancreatitis  and the suspect product comirnaty cannot be excluded. The case will be reassessed once new information is available.  The impact of this report on the benefit/risk profile of the Pfizer drug is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, and Investigators, as appropriate.