Recurrent Acute Pancreatitis Probably Induced by Rosuvastatin Therapy: A Case Report

Abstract

Context. Approximately 1.4–2% of all cases of acute pancreatitis are drug related in general population. The literature on statin-induced pancreatitis consists primarily of anecdotal case reports. We report a case of possible rosuvastatin-induced pancreatitis. Case Report. A 67-year-old female presented with progressively worsening abdominal pain and vomiting for 7 days. Home medications included rosuvastatin and clonidine. CT scan of abdomen, with intravenous contrast, showed findings consistent with acute pancreatitis. She responded to conservative management. Rosuvastatin was resumed at the time of discharge from the hospital, and she presented two months later with recurrence of acute pancreatitis. Further workup ruled out all likely causes of acute pancreatitis. Rosuvastatin was stopped completely when she was discharged the second time, and she did not have any further episodes of acute pancreatitis. She was completely asymptomatic throughout the 18-month follow-up period. Conclusion. This paper reinforces the possible association of rosuvastatin, a novel statin, with acute pancreatitis, even though the exact underlying mechanism of statin-induced pancreatitis remains unknown.

Rosuvastatin and risk of acute pancreatitis in a population-based case–control study

“…It indicates that only patients still continuing to ingest rosuvastatin might have the odds, but those who once ingested rosuvastatin but are not ingesting it now do not have the odds of acute pancreatitis. To date, only two cases have been reported that rosuvastatin could be associated with acute pancreatitis, including one case having re-challenge confirmation of a causal relationship [6], and another case with probable association due to no receiving rechallenge test [5]. To the best of our knowledge, this is the first population-based case-control study to test the association focusing on rosuvastatin use only and acute pancreatitis.…”

“…Its rare adverse effects include myopathy, elevation of creatine kinase and liver function test abnormalities [2][3][4]. In addition, two cases have been reported that rosuvastatin could be associated with acute pancreatitis [5,6]. The U.S. Food and Drug Administration has also reported that from 2003 to 2014, 483 people (0.84%) had pancreatitis among 57,750 people reporting to have side effects when ingesting rosuvastatin [7].…”

Statins and their role in acute pancreatitis: Case report and literature review

“…As such, their remains a dearth of concrete experimental evidence regarding the precise mechanism of action for the reported cases of statin-induced pancreatitis. Interestingly, the majority of documented instances in which statins have been reintroduced, demonstrate reproducibility of acute pancreatitis and/or symptoms consistent with this diagnosis [8,13,[19][20][21] . However, these findings have not been universal as Belaiche and colleagues have documented a patient who tolerated pravastatin prior to and following an episode of atorvastatin-induced pancreatitis [22] .…”

A generalised sensation of coldness following introduction of rosuvastatin therapy

“…Other adverse effects have been reported in the context of case-report studies, such as pemphigoid,7 erythema multiforme,8 erythromelalgia,9 recurrent pancreatitis,10 11 thrombocytopaenia,12 gynaecomastia,13 as well as short-term memory loss 14. These unusual adverse effects are currently anecdotal and occurred with doses of rosuvastatin between 5 and 40 mg daily.…”