• Abstract
  • References
  • Cite This Article as
  • Corresponding Author

Introduction: Saw palmetto is a phytotherapeutic agent commercially marketed for the treatment of benign prostatic hyperplasia. Evidence suggests that saw palmetto is a safe product, and mild gastrointestinal adverse effects have been reported with its use. We report a case of acute pancreatitis, possibly secondary to the use of saw palmetto. Case presentation: A 61-year-old Caucasian man with a history of benign prostatic hyperplasia and gastroesophageal reflux disease developed epigastric pain associated with nausea 36 hours prior to presentation. He denied drinking alcohol prior to the development of his symptoms. His home medications included saw palmetto, lansoprazole and multivitamins. Laboratory results revealed elevated lipase and amylase levels. An abdominal ultrasound demonstrated a nondilated common bile duct, without choledocholithiasis. Computed tomography of his abdomen showed the pancreatic tail with peripancreatic inflammatory changes, consistent with acute pancreatitis. Our patient\'s condition improved with intravenous fluids and pain management. On the fourth day of hospitalization his pancreatic enzymes were within normal limits: he was discharged home and advised to avoid taking saw palmetto. Conclusion: It is our opinion that a relationship between saw palmetto and the onset of acute pancreatitis is plausible, and prescribers and users of saw palmetto should be alert to the possibility of such adverse reactions.

  1. United States Department of Agriculture, Agricultural Research Service, National Genetics Resources Program: Germplasm Resources Information Network. GRIN Taxonomy for Plants--Serenoarepens (W. Bartram) Small.?http://www.ars-grin.gov/cgi-bin/npgs/html/taxon.pl?103108
  2. George W, Tanner G, Mullahey J, Maehr D: Saw-palmetto: An ecologically and economically important native palm. WEC-109. 1999, Gainesville: University of Florida Institute of Food and Agriculture Sciences,?http://www.plantapalm.com/vpe/misc/saw-palmetto.pdfGoogle Scholar
  3. Ravenna L, Di Silverio F, Russo MA, Salvatori L, Morgante E, Morrone S, Cardillo MR, Russo A, Frati L, Gulino A, Petrangeli E: Effects of the lipidosterolic extract of Serenoarepens (Permixon) on human prostatic cell lines. Prostate. 1996, 29 (4): 219-230. 10.1002/(SICI)1097-0045(199610)29:4<219::AID-PROS3>3.0.CO;2-6.View ArticlePubMedGoogle Scholar
  4. Carilla E, Briley M, Fauran F, Sultan C, Duvilliers C: Binding of Permixon: a new treatment for prostatic benign hyperplasia, to the cytosolic androgen receptor in the rat prostate. J Steroid Biochem. 1984, 20 (1): 521-523. 10.1016/0022-4731(84)90265-6.View ArticlePubMedGoogle Scholar
  5. Bayne CW, Donnelly F, Ross M, Habib FK: Serenoarepens (Permixon): a 5-alpha-reductase types I and II inhibitor--new evidence in a coculture model of BPH. Prostate. 1999, 40 (4): 232-241. 10.1002/(SICI)1097-0045(19990901)40:4<232::AID-PROS4>3.0.CO;2-0.View ArticlePubMedGoogle Scholar
  6. Goldmann WH, Sharma AL, Currier SJ, Johnston PD, Rana A, Sharma CP: Saw palmetto berry extract inhibits cell growth and Cox-2 expression in prostatic cancer cells. Cell Biol Int. 2001, 25 (11): 1117-1124. 10.1006/cbir.2001.0779.View ArticlePubMedGoogle Scholar
  7. Wilt TJ, Ishani A, Stark G, MacDonald R, Lau J, Mulrow C: Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA. 1998, 280 (18): 1604-1609. 10.1001/jama.280.18.1604.View ArticlePubMedGoogle Scholar
  8. Dimitrakov JD: Saw palmetto for benign prostatic hyperplasia. N Engl J Med. 2006, 354 (18): 1950-1951.View ArticlePubMedGoogle Scholar
  9. Tacklind J, MacDonald R, Rutks I, Wilt TJ:?Serenoarepensfor benign prostatic hyperplasia. Cochrane Database Syst Rev. 2009, 15 (2): CD001423-Google Scholar
  10. Agbabiaka TB, Pittler MH, Wider B, Ernst E:?Serenoarepens(Saw palmetto): a systematic review of adverse events. Drug Saf. 2009, 32 (8): 637-647. 10.2165/00002018-200932080-00003.View ArticlePubMedGoogle Scholar
  11. Hamid S, Rojter S, Vierling J: Protracted cholestatic hepatitis after the use of prostata. Ann Intern Med. 1997, 127 (2): 169-170.View ArticlePubMedGoogle Scholar
  12. Jibrin I, Erinle A, Saidi A, Aliyu ZY: Saw palmetto-induced pancreatitis. South Med J. 2006, 99 (6): 611-612. 10.1097/01.smj.0000215642.76198.44.View ArticlePubMedGoogle Scholar
  13. Wargo A, Allman E, Ibrahim F: A possible case of saw palmetto-induced pancreatitis. South Med J. 2010, 103: 683-685. 10.1097/SMJ.0b013e3181e1e3ee.View ArticlePubMedGoogle Scholar
  14. Fagenholz PJ, Castillo CF, Harris NS, Pelletier AJ, Camargo CA: Increasing United States hospital admissions for acute pancreatitis, 1988-2003. Ann Epidemio. 2007, 17: 491-497.View ArticleGoogle Scholar
  15. Lowenfels AB, Maisonneuve P, Sullivan T: The changing character of acute pancreatitis: epidemiology, etiology, and prognosis. CurrGastroenterol Rep. 2009, 11: 97-103. 10.1007/s11894-009-0016-4.View ArticlePubMedGoogle Scholar
  16. Forsmark CE, Baillie J, AGA Institute Clinical Practice and Economics Committee: AGA Institute technical review on acute pancreatitis. Gastroenterology. 2007, 132 (5): 2022-2044. 10.1053/j.gastro.2007.03.065.View ArticlePubMedGoogle Scholar
  17. Runzi M, Layer P: Drug-associated pancreatitis: facts and fiction. Pancreas. 1996, 13 (1): 100-109. 10.1097/00006676-199607000-00014.View ArticlePubMedGoogle Scholar
  18. Badalov N, Baradarian R, Iswara K, Li J, Steinberg W, Tenner S: Drug-induced acute pancreatitis: an evidence-based review. ClinGastroenterolHepatol. 2007, 5 (6): 648-661. 10.1016/j.cgh.2006.11.023.View ArticlePubMedGoogle Scholar
  19. Draganov P, Forsmark CE: \"Idiopathic\" pancreatitis. Gastroenterology. 2005, 128 (3): 756-763. 10.1053/j.gastro.2005.01.037.View ArticlePubMedGoogle Scholar
  20. Van Geenen EJ, van der Peet DL, Bhagirath P, Mulder CJ, Bruno MJ: Etiology and diagnosis of acute biliary pancreatitis. Nat Rev GastroenterolHepatol. 2010, 7 (9): 495-502. 10.1038/nrgastro.2010.114.View ArticlePubMedGoogle Scholar
  21. American Gastroenterological Association (AGA) Institute on Management of Acute Pancreatitis, Clinical Practice and Economics Committee; AGA Institute Governing Board: AGA Institute medical position statement on acute pancreatitis. Gastroenterology. 2007, 132 (5): 2019-2021. 10.1053/j.gastro.2007.03.066.View ArticleGoogle Scholar
  22. Ballinger AB, Barnes E, Alstead EM, Fairclough PD: Is intervention necessary after a first episode of acute idiopathic pancreatitis?. Gut. 1996, 8 (2): 293-295.View ArticleGoogle Scholar
  23. Delhaye M, Cremer M: Clinical significance of pancreas divisum. ActaGastroenterol Belg. 1992, 5 (3): 306-313.Google Scholar
  24. Eland IA, Alvarez CH, Stricker BH, Rodr?guez LA: The risk of acute pancreatitis associated with acid-suppressing drugs. Br J ClinPharmacol. 2000, 49 (5): 473-478.View ArticlePubMedPubMedCentralGoogle Scholar
  25. Sundstr?m A, Blomgren K, Alfredsson L, Wiholm BE: Acid-suppressing drugs and gastroesophageal reflux disease as risk factors for acute pancreatitis results from a Swedish Case-Control Study. Pharmacoepidemiol Drug Saf. 2006, 15 (3): 141-149. 10.1002/pds.1137.View ArticlePubMedGoogle Scholar
  26. De Bernardi DVM, Tripodi AS, Contos S: Serenoarepens capsules: a bioequivalence study. ActaToxicolTher. 1994, 15: 21-39.Google Scholar
  27. Tenner S, Dubner H, Steinberg W: Predicting gallstone pancreatitis with laboratory parameters: a meta-analysis. Am J Gastroenterol. 1994, 89 (10): 1863-1866.PubMedGoogle Scholar
  28. Underwood TW, Frye CB: Drug-induced pancreatitis. Clin Pharm. 1993, 12 (6): 440-448.PubMedGoogle Scholar
  29. Kaurich T: Drug-induced acute pancreatitis. Proc (BaylUniv Med Cent). 2008, 21: 77-81.Google Scholar
  30. Food, Dietary supplements: U.S Food and Drug Administration.http://www.fda.gov/food/dietarysupplements/default.htm

[Rawan Abdul Rahim Alaeq, Muhjah Abdulhakimturdi Bukhari , Saud Zuail Alrashedi , Ghadah Abdulrahman Albalawi , Ibrahim Yahya Ahmed Alzilai, Yousef Hassan Alfaqih , Abdullah Mohammed Ali Abutaleb and Raied Eid Almalki. (2017); CASE OF ACUTE PANCREATITIS: A CASE REPORT AUTHORS. Int. J. of Adv. Res. 5 (12). 48-54] (ISSN 2320-5407). www.journalijar.com

Shehab mesfer Almalki


Article DOI: 10.21474/IJAR01/5936       DOI URL: http://dx.doi.org/10.21474/IJAR01/5936

Share this article