Drug-induced Pancreatic Atrophy (“The Vanishing Pancreas”)

Immune checkpoint inhibitors have become the therapeutic mainstay in a rapidly growing number of cancers. Immune checkpoint inhibitor-related diarrhea is attributed mainly to inflammatory colitis, with no other drug-related differential diagnosis. However, other causes of diarrhea should be considered. Pancreatic atrophy (and exocrine pancreatic insufficiency) is a relatively rare complication of immune checkpoint inhibitors. Herein we bring a set of striking computed tomography (CT) images that demonstrate a drug-related-progressive pancreatic atrophy until complete vanishing of pancreatic tissue. Exocrine pancreatic insufficiency (EPI) was diagnosed. Pancreatic enzyme replacement therapy was initiated with an excellent clinical response. How to cite this article: Khamaysi I, Hajj E. Drug-induced Pancreatic Atrophy (“The Vanishing Pancreas”). Euroasian J Hepato-Gastroenterol 2020;10(2):101–102.