Case Report Acute Pancreatitis and Diabetic Ketoacidosis following L-Asparaginase/Prednisone Therapy in Acute Lymphoblastic Leukemia Dania Lizet Quintanilla-Flores, 1 Miguel Ángel Flores-Caballero, 1 René Rodríguez-Gutiérrez, 1 Héctor Eloy Tamez-Pérez, 2 and José Gerardo González-González 2 1 Internal Medicine Department, “Dr. Jos´ e Eleuterio Gonz´ alez” University Hospital and School of Medicine, Universidad Aut´ onoma de Nuevo Le´ on, Avenida Francisco I. Madero pte. y Avenida Gonzalitos s/n, Colonia Mitras Centro, 64460 Monterrey, NL, Mexico 2 Research Division, School of Medicine, Universidad Aut´ onoma de Nuevo Le´ on, Avenida Francisco I. Madero pte. y Avenida Gonzalitos s/n, Colonia Mitras Centro, 64460 Monterrey, NL, Mexico Correspondence should be addressed to Miguel ´ Angel Flores-Caballero; drlorescaballero@hotmail.com Received 24 November 2013; Accepted 29 December 2013; Published 10 February 2014 Academic Editors: L. Beex, C. Gennatas, and J. I. Mayordomo Copyright © 2014 Dania Lizet Quintanilla-Flores et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Acute pancreatitis and diabetic ketoacidosis are unusual adverse events following chemotherapy based on L-asparaginase and prednisone as support treatment for acute lymphoblastic leukemia. We present the case of a 16-year-old Hispanic male patient, in remission induction therapy for acute lymphoblastic leukemia on treatment with mitoxantrone, vincristine, prednisone, and L-asparaginase. He was hospitalized complaining of abdominal pain, nausea, and vomiting. Hyperglycemia, acidosis, ketonuria, low bicarbonate levels, hyperamylasemia, and hyperlipasemia were documented, and the diagnosis of diabetic ketoacidosis was made. Because of uncertainty of the additional diagnosis of acute pancreatitis as the cause of abdominal pain, a contrast-enhanced computed tomography was performed resulting in a Balthazar C pancreatitis classiication. 1. Introduction he long-term outcome of acute lymphoblastic leukemia (ALL) has improved dramatically during the last few decades because of the development of well-designed and efective treatment protocols. Since 1961, L-asparaginase, combined with danorubicin, vincristine, and prednisone, the corner- stone treatment for ALL. hey are used in remission, induc- tion, and intensiication phases in all pediatric regimens and in the majority of adult treatment protocols [1, 2]. Long-term, event-free, survival rates in children are currently around 80% and overall survival rates are close to or exceeding 90% of pediatric patients. Although overall survival rates in adults have improved in recent years, only 38% to 50% achieve long- term survival [3]. he most common complications associated with L- asparaginase are abdominal pain and allergic reactions. Other side efects include liver dysfunction, coagulation defects and central nervous system depression. Moreover, acute pancreatitis (AP), hyperglycemia, and diabetic ketoacidosis (DKA) can also be present [4]. Even though these side efects are well known, the combination of both DKA and AP represents unusual conditions generally reported as benign and self-limited [5]. We report a case of a 16-year-old male patient who devel- oped transient diabetes mellitus following L-asparaginase therapy with ketoacidosis and acute pancreatitis as the mode of presentation. 2. Case Presentation A 16-year-old Hispanic male patient was admitted to our hospital. He was diagnosed as having acute lymphoblastic leukemia 5 months earlier. He was during the remission Hindawi Publishing Corporation Case Reports in Oncological Medicine Volume 2014, Article ID 139169, 3 pages http://dx.doi.org/10.1155/2014/139169