Recurrent acute pancreatitis in a patient with acquired glutaric aciduria type II: a case report

Abstract

Acquired glutaric aciduria type II (GAII) is an emerging metabolic disorder linked to mitochondrial dysfunction, which may predispose patients to recurrent pancreatitis due to impaired fatty acid metabolism. This report presents the first documented instance of recurrent acute pancreatitis in a patient with acquired GAII. A 30-year-old Caucasian female with a known diagnosis of acquired GAII presented with recurrent episodes of acute pancreatitis, including two episodes during pregnancy and one outside pregnancy. Thorough investigations systematically excluded common causes such as gallstones, alcohol use, hypertriglyceridemia, IgG4-related disease, autoimmune pancreatitis and anatomical anomalies. Management required multidisciplinary collaboration involving surgeons, obstetricians, metabolic specialists and medical physicians. Treatment involved conservative surgical management including intravenous fluid resuscitation, analgesia, anti-emetics and specialized metabolic support, particularly intravenous dextrose while fasting. This case highlights the importance of recognizing acquired GAII as a potential underlying cause of recurrent acute pancreatitis. Awareness among surgical and multidisciplinary teams is crucial for timely diagnosis and effective management to prevent severe complications.