Hemolysis can trigger pancreatitis. Various mechanisms have been proposed, including the release of free heme or of cytokines.
(1) The patient is initially without evidence of pancreatitis.
(2) The patient undergoes a hemolytic episode (hemolytic transfusion reaction, hemolytic anemia, other).
(3) The patient develops an acute pancreatitis following the onset of the hemolysis, with epigastric and/or back pain, hyperamylasemia, and pancreatic swelling on imaging studies.
(4) No other condition can explain the pancreatitis.
(5) The patient may experience recurrent episodes of pancreatitis with a recurrent episode of hemolysis.
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