An Unexpected Result of Obesity Treatment: Orlistat-Related Acute Pancreatitis

Abstract

Orlistat is a pancreatic lipase inhibitor which is used to treat obesity. Due to the increasing prevalence of obesity, orlistat use is thought to rise progressively. We report an interesting case caused by orlistat use caught in the early stages of acute pancreatitis through imaging; in addition, the case had significantly elevated serum amylase levels. A 54-year-old male who had a history of orlistat treatment started 7 days before was admitted to the emergency department with complaints of abdominal pain, nausea and vomiting lasting for 24 h. Abdominal computed tomography revealed peripancreatic fat tissue edema and a heterogeneous appearance of the pancreas. Based on these findings, it was concluded that edematous pancreatitis was in its initial stage. Orlistat is a drug that is increasingly widespread use due to obesity. More attention must be paid when planning to prescribe orlistat to patients if there are risk factors for acute pancreatitis (alcohol use, height, serum calcium and lipid levels).

Light and Electron Microscopic Study of the Effect of Orlistat on the Liver of Adult Male Albino Rats and the Possible Protective Role of <i>β</i>-Carotene

“…Orlistat is metabolized in the gastrointestinal tract and its direct damaging effect is publicized in intestinal villi of animal models [13]. Pancreatitis associated with the use of orlistat was also recorded by several investigators [14] [15]. The effect of orlistat on the liver is still a matter of controversy.…”

Effect of Orlistat on the pancreas of the female albino rat: Histological and Histochemical study

“…It has been reported that there has been an association between the use of orlistat and development of pancreatitis in some cases clinically with no evidence of biliary disease or alcohol consumption [7] .…”

Hesperidin improves insulin resistance via down-regulation of inflammatory responses: Biochemical analysis and in silico validation

“…Although, a very few cases have been reported for clinical sign of acute liver injury caused by orlistat, in 2010, food and drug administration (FDA) proclaimed safety concerns regarding orlistat-induced liver injury. Among reported cases, the onset of injury was observed to be between 2 to 12 weeks of starting orlistat [13]. Similarly, it has been suggested after evaluating the effects of orlistat on live that idiosyncratic liver damage related to orlistat cannot be neglected, it is likely to be extremely rare.…”