A 65-year-old female patient with a history of rheumatoid arthritis who was recently started on etanercept therapy, presented with abdominal pain. She denied a history of alcohol use, trauma, or gallstones and workup yielded a lipase of 1012U/L with normal remaining lab work. Imaging would not indicate evidence of biliary obstruction. The patient was medically managed for pancreatitis, suspected in the setting of etanercept use. She was managed medically with fluid resuscitation and diet advanced as tolerated. She was advised to refrain from etanercept and is symptom-free at one year follow up. The lack of extensive prior trials and studies has prevented consensus guidelines on drug-induced pancreatitis. It is vital to rule out common etiologies such as obstruction, trauma, alcohol use and lab abnormalities. A high index of suspicion is vital for management and preventing recurrence. Etanercept is being increasingly used for a variety of autoimmune conditions and its association with acute pancreatitis is not well known. Further studies are needed to clarify this adverse effect.

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