M. A. Assili, M. Belaich, A. El Marzouqi, M. Zouaoui, M. Azouaoui, N. Aqodad

Department of Gastroenterology, Souss Massa University Hospital, Agadir, Morocco

Corresponding Author: M. A. Assili, Department of Gastroenterology, Souss Massa University Hospital, Agadir, Morocco.

Citation: M. A. Assili, M. Belaich, A. El Marzouqi, M. Zouaoui, M. Azouaoui, N. Aqodad (2025). Beyond Gallstones and Alcohol: Acute Pancreatitis as a Sentinel Event of Primary HIV. American J Case Rep Clin Imag. 2025; September, 22, 1-3.

Copyrights © 2025, M. A. Assili, et al., This article is licensed under the Creative Commons Attribution-Non-Commercial-4.0-International-License-(CCBY-NC) (https://americanjournalofcasereports.com/blogpage/copyright-policy). Usage and distribution for commercial purposes require written permission.

Abréviation:

• ·                 ·         Acute Pancreatitis (AP)

·        Human Immunodeficiency Virus (HIV)

·        World Health Organization (WHO)

·        White Blood Cells (WBC)

·        Intensive Care Unit (ICU)

·        Antiretroviral Therapy (ART)

·        Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs)

·        Cluster Of Differentiation 4 (CD3)

Abstract:

Acute Pancreatitis (AP) is an abrupt inflammation of the pancreas with diverse causes. Gallstones and alcohol account for approximately 70–80% of cases [1]. Other causes include metabolic disorders, medications, and, rarely, systemic infections. We present a 48-year-old woman with new-onset type 2 diabetes who was admitted for severe epigastric pain and acute kidney injury. She had no history of alcohol use or pancreatitis-inducing drugs. Laboratory tests showed leukocytosis with marked lymphopenia; serum amylase was ~8× normal. Given the lymphopenia, Human Immunodeficiency Virus (HIV) serology was performed and returned positive, indicating acute HIV-1 infection. Contrast CT confirmed interstitial pancreatitis (Balthazar grade C) without necrosis. The patient received aggressive IV fluids, electrolyte repletion, and early enteral nutrition, and was started on antiretroviral therapy according to World Health Organization (WHO) guidelines [8]. Her condition improved over two weeks with normalization of enzymes and renal function. This case underscores that acute (primary) HIV infection can rarely present as unexplained acute pancreatitis, and suggests HIV testing in idiopathic pancreatitis, especially when accompanied by immunologic abnormalities like lymphopenia [3].