Üriner Semptomlar İçin Kullanılan Saw Palmettonun Neden Olduğu Koagülopati ve Pankreatit Gelişimi

Year 2024, Volume: 7 Issue: 2, 91 - 94, 29.06.2024

Muhammet Şencan , Nurettin Özgür Doğan

https://doi.org/10.54996/anatolianjem.1291882

Abstract

Amaç: Yaygın kullanımıyla saw palmetto olarak bilinen serenoa repens, alt üriner sistem semptomları için sıkça kullanılan bir bitkisel takviyedir. Bununla birlikte, bu besin takviyesinin toksisitesine ilişkin veriler sınırlıdır. Bu çalışmada, saw palmetto gibi bitkisel ekstrelerin pıhtılaşma bozukluğu ve pankreatite yol açabileceğinin vurgulanması amaçlanmaktadır.

Olgu Sunumu: Bu vaka raporunda, üriner taş hastalığı ve idrar yolu semptomları için saw palmetto ekstresi kullanan 60 yaşında bir erkek hasta sunulmaktadır. Hastanın dil ucunda, gövde ve ekstremitelerinde yaygın ekimozları mevcuttu. Herhangi bir antikoagülan ilaç kullanmayan hastanın koagülometre testleri uzamış; böbrek yetmezliği degelişmişti. Pıhtılaşma bozukluğunu tedavi etmek için K vitamini ve taze donmuş plazma kullanıldı. Tedavisini takip eden günlerde akut pankreatit de gelişen hasta ek komplikasyon gelişmeden tedavisinin 15. gününde taburcu edildi.

Sonuç: Bitkisel takviyeler tıbbi uygulamada yaygın olarak kullanılmaktadır. Saw palmetto ekstrelerinin karın ağrısı, baş ağrısı, hepatotoksisite, koagülopati ve pankreatit gibi farklı yan etkileri olabilir. Bu takviyeleri kullanan hastalar, saw palmettonun bu etkilerinin farkında olmalıdır.

Keywords

Saw palmetto ekstres, serenoa, kan pıhtılaşma bozuklukları, pankreatit, acil servis

Development of Coagulopathy and Pancreatitis Due to Saw Palmetto Used for Urinary Symptoms

Abstract

Aim: Serenoa repens, commonly known as saw palmetto, is a widely used herbal supplement for lower
urinary tract symptoms. However, data regarding the toxicity of this dietary supplement is limited. In this study, it is aimed to emphasize that herbal extracts such as saw palmetto can cause coagulation disorder and pancreatitis.

Case Presentation: In this case report, we present a 60 year-old male patient using saw palmetto extract for urinary stone disease and urinary tract symptoms. The patient had widespread ecchymoses on the tip of the tongue, trunk and extremities. The coagulometric tests of the patient, who did not use any anticoagulant drugs, were prolonged; renal failure had also developed. Vitamin K and fresh frozen
plasma were used to treat the coagulopathy. The patient, who also developed acute pancreatitis in the days following hospitalization, was discharged on the 15th day without any additional complications.

Conclusion: Herbal supplements are widely used in medical practice. Saw palmetto extracts may have different adverse effects including abdominal pain, headache, hepatotoxicity, coagulopathy, and pancreatitis. Patients using these supplements should be aware of these effects of saw palmetto.

Keywords

Saw palmetto extract, serenoa, blood coagulation disorders, pancreatitis, emergency department

References

• Singh YN, Devkota AK, Sneeden DC, et al. Hepatotoxicity potential of saw palmetto (Serenoa repens) in rats. Phytomedicine 2007;14:204-8. doi:10.1016/j.phymed.2006.03.024.
• Avins AL, Bent S, Staccone S, et al. A detailed safety assessment of a saw palmetto extract. Complement Ther Med 2008;16:147-54. doi: 10.1016/j.ctim.2007.10.005.
• Agbabiaka TB, Pittler MH, Wider B, et al. Serenoa repens (saw palmetto): a systematic review of adverse events. Drug Saf 2009;32:637-47. doi: 10.2165/00002018-200932080-00003.
• Avins AL, Lee JY, Meyers CM, et al. Safety and toxicity of saw palmetto in the CAMUS trial. J Urol 2013;189:1415-20. doi:10.1016/j.juro.2012.10.002.
• Jibrin I, Erinle A, Saidi A, et al. Saw palmetto-induced pancreatitis. South Med J 2006;99:611-2. doi: 10.1097/01.smj.0000215642.76198.44.
• Wang CZ, Moss J, Yuan CS. Commonly Used Dietary Supplements on Coagulation Function during Surgery. Medicines (Basel) 2015;2:157-185. doi: 10.3390/medicines2030157.
• Andriole GL, McCullum-Hill C, Sandhu GS, et al. The effect of increasing doses of saw palmetto fruit extract on serum prostate specific antigen: analysis of the CAMUS randomized trial. J Urol 2013;189:486-92. doi: 10.1016/j.juro.2012.09.037.
• Barry MJ, Meleth S, Lee JY, et al. Effect of increasing doses of saw palmetto extract on lower urinary tract symptoms: a randomized trial. JAMA 2011;306:1344-51. doi:10.1001/jama.2011.1364.
• Bent S, Kane C, Shinohara K, et al. Saw palmetto for benign prostatic hyperplasia. N Engl J Med 2006;354:557-66. doi:10.1056/NEJMoa053085.
• Cheema P, El-Mefty O, Jazieh AR. Intraoperative haemorrhage associated with the use of extract of Saw Palmetto herb: a case report and review of literature. J Intern Med 2001;250:167-9.doi: 10.1046/j.1365-2796.2001.00851.x.
• Villanueva S, González J. Coagulopathy induced by saw palmetto: a case report. Bol Asoc Med P R 2009;101:48-50.
• Lapi F, Gallo E, Giocaliere E, et al. Acute liver damage due to Serenoa repens: a case report. BrJ Clin Pharmacol 2010;69:558-60. doi: 10.1111/j.1365-2125.2010.03618.x.
• Wargo KA, Allman E, Ibrahim F. A possible case of saw palmetto-induced pancreatitis. South Med J 2010;103:683-5. doi: 10.1097/SMJ.0b013e3181e1e3ee.
• Bruminhent J, Carrera P, Li Z, et al. Acute pancreatitis with saw palmetto use: a case report. J Med Case Rep 2011;5:414. doi:10.1186/1752-1947-5-414.