A Fatal Case of Metformin Induced Severe Acute Pancreatitis Precipitated by Acute Renal Failure

Metformin is a biguanide, and it is one common type of oral anti-diabetic drugs for type 2 diabetic patients. Its most common complication is gastrointestinal discomfort. Lactic acidosis is a rare but fatal complication when metformin is prescribed to the patient with impaired renal function. Acute pancreatitis may be caused by some drugs, but it is seldom reported to be induced by metformin therapy. We report a 63-year-old female who suffered from acute pancreatitis, lactic acidosis and acute renal failure. We excluded particular causes of pancreatitis, such as biliary stones or sludge, alcohol use, hypertriglyceridemia, or hypercalcemia. Metformin induced acute pancreatitis precipitated by acute renal failure was confirmed.