Document Detail


A possible case of saw palmetto-induced pancreatitis.
MedLine Citation:
PMID:  20531057     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 65-year-old male with a history of diabetes, hypertension, hyperlipidemia, gout, Barrett esophagitis, and chronic gastritis developed acute pancreatitis after taking one week of the herbal medicine, saw palmetto, for symptoms related to benign prostatic hyperplasia (BPH). Ultrasound and computed tomography ruled out cholelithiasis and obstruction, triglycerides were normal, and he had no recent infection or trauma. He had a history of occasional alcohol consumption, though there was no recent increased intake. The most likely cause of pancreatitis in this case was saw palmetto. Saw palmetto (Serenoa repens) is an herbal medication used primarily in the treatment of symptoms related to BPH. It has a high content of fatty acids and phytosterols which are thought to exert their effects by inhibiting the enzyme 5-alpha-reductase, thereby preventing the conversion of testosterone into dihydrotestosterone (DHT). It has been postulated that saw palmetto directly stimulates estrogenic receptors and inhibits progesterone receptors in the prostate tissue. A previous report implicated the estrogen/antiandrogen properties of saw palmetto as inducing hepatotoxicity in a patient. Additionally, it has also been postulated that stimulation of the estrogenic receptors may lead to increased triglyceride levels or induction of a hypercoagulable state that leads to pancreatic necrosis. Finally, inhibition of cyclooxygenase, a property of saw palmetto, may be linked to acute pancreatitis. Acute pancreatitis, a serious and sometimes fatal disorder may occur secondary to medications. Although the mechanism is not fully known, this is the second case of acute pancreatitis that has been documented secondary to the herbal medication saw palmetto. It is important for clinicians to obtain detailed medication histories, including over-the-counter and herbal medications, in order to prevent further complications from occurring.
Authors:
Kurt A Wargo; Elena Allman; Farrah Ibrahim
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Southern medical journal     Volume:  103     ISSN:  1541-8243     ISO Abbreviation:  South. Med. J.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-30     Completed Date:  2010-07-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404522     Medline TA:  South Med J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  683-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, AL, USA. wargoka@auburn.edu
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Humans
Male
Pancreatitis / chemically induced*,  diagnosis
Phytotherapy / adverse effects*
Plant Extracts / adverse effects*,  therapeutic use
Prostatic Hyperplasia / drug therapy*
Chemical
Reg. No./Substance:
0/Permixon; 0/Plant Extracts
Comments/Corrections
Comment In:
South Med J. 2010 Jul;103(7):605-6   [PMID:  20531044 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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