Objective: To analyze the clinical manifestations and etiology of acute pancreatitis in children with nephrosis after tacrolimus treatment

and to explore the correlation between tacrolimus and acute pancreatitis

so as to provide a reference for making reasonable diagnosis and treatment regimens in clinical practice. Methods: The medical records of 2 children with acute pancreatitis after tacrolimus treatment in the Pediatric Nephrology and Rheumatic Immunology Department of Shengjing Hospital of China Medical University from 2018 to 2020 were retrospectively analyzed. Results: Acute pancreatitis occurred in 2 children during tacrolimus treatment

including digestive system symptoms and signs

such as typical upper abdominal pain

blood amylase and lipase increased by more than 3 times

and imaging consistent with the change of pancreatitis. After discontinuation of tacrolimus

fasting for solids and liquids

inhibition of gastric acid secretion and other supportive treatments

the clinical symptoms

laboratory examination

and the imaging returned to normal. Conclusion: For children with renal rheumatic immune system diseases

we should be alert to the occurrence of acute pancreatitis when using tacrolimus

pay close attention to the symptoms and signs of children

timely improve the laboratory examination of blood amylase

lipase

urine amylase and pancreatic imaging examination

and realize early diagnosis and treatment

thus preventing systemic damage caused by disease progression.