Massive hepatocellular [correction of hepatocullular] necrosis: was it caused by Orlistat?
Orlistat (tetrahydrolipostatin) is a lipase inhibitor which is used, in conjunction with appropriate dietary control, for the treatment of obesity. It is generally deemed to be a safe drug, which mainly exerts a topical action on the stomach and small bowel, with negligible systemic absorption and oral bioavailability. Consequently, its adverse effects have largely been limited to relatively mild gastrointestinal disorders. However, there have been recent, published reports of non-fatal acute hepatitis and systemic hypertension associated with its use. The present case concerns a 62-year-old male who died from massive hepatocellular necrosis, consistent with drug-induced, fulminant hepatitis, associated with the use of oral orlistat, presumably administered at the recommended daily dose of 360 mg. It is postulated that this may represent a rare idiosyncratic reaction to the drug.
Lau
Gilbert
G
Health Sciences Authority, Centre for Forensic Medicine, Singapore, Republic of Singapore. Gilbert_LAU@HSA.GOV.SG
Chan
Cheng Leng
CL
D019440:Anti-Obesity Agents / Q000009:adverse effects* / Q000378:metabolism / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D007783:Lactones / Q000009:adverse effects* / Q000378:metabolism / Q000627:therapeutic use; D017093:Liver Failure / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D000077403:Orlistat
D019440:Anti-Obesity Agents; D007783:Lactones; D000077403:Orlistat