Most patients do not realize however that the Food and Drug Administration (FDA) does not require manufacturers to report the safety and efficacy of these drugs before they are marketed. Consumers often consider herbal supplements to be safer than standard medical treatment because they are termed “natural” and thus promote a sense of health and well-being under a patient’s control. The use of herbal supplements continues to rise as an alternative to conventional medical treatment. After a thorough workup to exclude other causes, our case demonstrates consistent resolution of symptoms and pancreatic enzymes along with normal imaging following discontinuation of the offending agent. We describe the first reported case of drug-induced pancreatitis from beta-sitosterol, a common phytosterol found in many over the counter supplements worldwide. The patient was advised to avoid beta-sitosterol, and thus continued to remain asymptomatic. In the absence of classical risk factors for acute pancreatitis, a diagnosis of drug-induced pancreatitis secondary to beta-sitosterol was made. Abdominal magnetic resonance cholangiopancreatography obtained at follow-up appointment showed interval resolution of pancreatitis and normal biliary anatomy. At his follow-up appointment, the patient disclosed that he had started a new herbal supplement, beta-sitosterol, on the morning after his symptoms began. The patient was managed with aggressive intravenous hydration and supportive management and had resolution of symptoms. CT scan and ultrasound of the abdomen were remarkable for acute pancreatitis with acute necrotic collections and normal appearing gallbladder and bile ducts without the presence of gallstones. We present the first reported case of drug-induced pancreatitis from beta-sitosterol, a naturally occurring plant sterol structurally similar to cholesterol, obtained primarily through Western diet and supplementation.Ī 57-year-old male with a history of situs inversus and benign prostatic hyperplasia presented from an outside facility with a two-day history of worsening epigastric pain radiating to the right upper quadrant. While drug-induced pancreatitis from corticosteroids has been well described in the medical literature, the exact mechanism is unclear.
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