Macrocytic anemia and thrombocytopenia induced by orlistat.
BACKGROUND
The overall incidence of obesity and its prevalence is increasing continuously. The obesity is a cardiovascular risk factor whose importance is increasing too. It is associated with many chronic conditions such as type II diabetes mellitus or cardiovascular diseases. The obesity is also implicated as a risk factor for several kinds of cancer such as esophagus, pancreas, colon, rectum, breast cancer in menopausal women. The treatment of the obesity may reduce the incidence of these diseases. The mainstray of the treatment of obesity is changing the lifestyles, but obesity´s treatment may need drug therapy or even though surgical treatment. Orlistat is a specific inhibitor of gastrointestinal lipases, which stops fat absortion. It is used along with a hypocaloric diet, for obesity´s treatment. The beneficial effects of orlistat include weight loss, the improvement of blood pressure´s control, it may delay the development of diabetes mellitus, and it may reduce HbA1c.


METHODS
Besides the interaction with other drugs (mainly warfarin and amiodarone). Orlistat´s mainly side effects are gastrointestinal disorders such as the existence of oily spotting from the rectum, abdominal pain or discomfort, fecal urgency. There are also side effects at other levels, like flu symptoms, hypoglycemia, heathache or upper respiratory infections. There are other side effects with very low incidence but clinically relevant like pancreatitis, subacute liver failure, severe liver disease, myopathy, or tubular necrosis secondary to oxalate nephropathy induced by Orlistat.


CONCLUSIONS
IN THIS CASE REPORT APPEARS A NEW ADVERSE EFFECT OF ORLISTAT THAT HAS NOT BEEN DESCRIBED ABOVE: thrombopenia and macrocytic anemia.
San Blas Health Center, Primary Health Care, SERMAS- Madrid Health Service, Parla, Madrid, Spain.
David
D
Palacios-Martinez
Local Office of Serranillos del Valle, Primary Health Care, SERMAS- Madrid Health Service, Griñón, Madrid, Spain.
Juan Carlos
JC
Garcia-Alvarez
San Blas Health Center, Primary Health Care, SERMAS- Madrid Health Service, Parla, Madrid, Spain.
Nieves
N
Montero-Santamaria
Service of Obstetrics and Gynecology, 12th October Universitary Hospital , SERMAS- Madrid Health Service, Madrid, Spain.
Olga Patricia
OP
Villar-Ruiz
Pinto Health Center, Primary Health Care: SERMAS- Madrid Health Service, Pinto, Madrid, Spain.
Antonio
A
Ruiz-Garcia
San Blas Health Center, Primary Health Care, SERMAS- Madrid Health Service, Parla, Madrid, Spain.
Raquel Asuncion
RA
Diaz-Alonso
Anti-Obesity Agents; Obesity; Obesity, Morbid; Thrombocytopenia