Dengue and Acute Pancreatitis: A Systematic Review.

Dengue fever typically presents as a febrile illness, and acute pancreatitis has been reported as a rare complication. Limited evidence exists regarding clinical features, imaging findings, and outcomes, particularly on the distinction between acute interstitial pancreatitis and acute necrotizing pancreatitis. This systematic review was therefore designed in accordance with PRISMA guidelines (PROSPERO ID: CRD420250631013) in order to characterize the clinical spectrum of dengue virus (DENV)-associated acute pancreatitis by recollecting available case reports from PubMed, EMBASE, Scopus, MedRxiv, and BioRxiv Case reports and case series, which were included if they described laboratory-confirmed DENV infection and met the diagnostic criteria for acute pancreatitis. Seventy cases of DENV-associated acute pancreatitis were identified, mostly from Asia (78.6%) and South America (17.1%). Patients were predominantly male (62.9%), with a mean age of 31.6 years. Acute interstitial pancreatitis was more common (65.7%) than acute necrotizing pancreatitis (34.3%). Acute necrotizing pancreatitis was associated with leukocytosis, pancreatic collections, multiorgan and respiratory failure, prolonged hospital stay, and higher mortality (25.0% vs. 4.3% for acute interstitial pancreatitis). Overall, the case fatality was 11.4%, and survival analysis demonstrated significantly worse outcomes for acute necrotizing pancreatitis. In summary, clinicians should maintain awareness of this complication, as early recognition and appropriate management may improve outcomes.