title: A case of acute pancreatitis possibly associated with combined salicylate and simvastatin treatment.
abstract: BACKGROUND
  Drug-induced acute pancreatitis is a rather rare clinical entity. From time to time, several cases have been reported in which statins or salicylates have been associated with the development of acute pancreatitis. There is only one report which implies the involvement of both drugs in pancreatic inflammation.
  
  
  METHODS
  A 58-year-old Caucasian male with a history of coronary heart disease and hypercholesterolemia, under treatment with acetyl-salicylate for 6 years and simvastatin for 2 months, presented to the Emergency Department of our hospital with epigastric pain and vomiting of 24-hour duration. The clinical and laboratory investigation led to the diagnosis of acute pancreatitis. Conservative and rich-in-fluid treatment resulted in clinical and laboratory amelioration, and the patient was discharged on day 15, after full restoration of his health. In our patient, all possible common causes of acute pancreatitis were excluded.
  
  
  CONCLUSIONS
  Conclusion It is a rational assumption to connect this case to the co-administration of simvastatin and acetyl-salicylate. However, the pathophysiological mechanism behind the onset of acute pancreatitis due to a statin, or, even more, due to its combination with salicylate, remains vague.
authors.affiliation: Second Department of Internal Medicine, Tzanio General Hospital of Piraeus, Athens, Greece.
authors.forename: Stavros
authors.initials: S
authors.lastname: Antonopoulos
authors.forename: Sotiris
authors.initials: S
authors.lastname: Mikros
authors.forename: Stelios
authors.initials: S
authors.lastname: Kokkoris
authors.forename: John
authors.initials: J
authors.lastname: Protopsaltis
authors.forename: Konstantina
authors.initials: K
authors.lastname: Filioti
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Karamanolis
authors.forename: Grigorios
authors.initials: G
authors.lastname: Giannoulis
mesh_terms: D000208:Acute Disease; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001241:Aspirin / Q000009:adverse effects* / Q000627:therapeutic use; D049448:Cholangiopancreatography, Magnetic Resonance; D003327:Coronary Disease / Q000188:drug therapy; D004359:Drug Therapy, Combination; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D019821:Simvastatin / Q000009:adverse effects* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000924:Anticholesteremic Agents; D019821:Simvastatin; D001241:Aspirin