Pancreatic panniculitis caused by L-asparaginase induced acute pancreatitis in a child with acute lymphoblastic leukemia.

Panniculitis caused by L-asparaginase induced acute pancreatitis is an unusual condition. We report a case of a 7-year-old Thai boy with underlying acute lymphoblastic leukemia who developed pancreatic panniculitis caused by L-asparaginase administration. During the second week of induction chemotherapy, the patient developed acute pancreatitis with septic shock. Two weeks later he developed multiple subcutaneous nodules on the abdominal wall. Skin excisional biopsy showed the typical histopathological features of pancreatic panniculitis. Acute pancreatitis improved after 3 weeks of conservative treatment. The skin lesions resolved spontaneously within 1 month.