A case of montelukast induced hypercholesterolemia, severe hypertriglyceridemia and pancreatitis

ABSTRACT

Montelukast sodium is a leukotriene inhibitor, and competitively antagonizes cys-LT1 receptor and used widely and effectively in treating allergic rhinitis, bronchial asthma and allied respiratory conditions. This case report outlines a rare case of montelukast induced hypercholesterolemia, severe hypertriglyceridemia and acute pancreatitis in a 22 years old male patient. The patient was taking 10 mg oral montelukast daily for allergic rhinitis. Although his symptoms improved considerably, after 2 months of therapy, he experienced unusual weight gain and got admitted with severe pain abdomen. Clinical and other relevant investigation findings revealed the presence of acute pancreatitis with associated hypercholesterolemia and severe hypertriglyceridemia. There were no evidences of any other possible hereditary, surgical, metabolic, infective, organic or other pathologic causes giving rise to these conditions. De-challenge was done and the patient was treated conservatively resulting in reversal of the diseased state. Naranjo adverse drug reaction probability scale suggested that it was ‘probable’ that oral administration of montelukast was responsible for the acute pancreatitis associated with hypercholesterolemia and severe hypertriglyceridemia. There is only a singular and confirmed reported case of montelukast induced hypertriglyceridemia from India. For patients taking montelukast for a long duration, routine lipid profile monitoring should be done, and if these patients present with symptoms of epigastric and periumbilical pain with vomiting, provisions for screening acute pancreatitis might be warranted.

KEYWORDS

• Allergic rhinitis
• Montelukast
• Hypercholesterolemia
• Hypertriglyceridemia
• Pancreatitis

Showing references and in-text citations exactly as published.

• DOI10.1016/j.jyp.2013.06.002Copy

RELATED ARTICLES

Matched on section and article type within this issue of JYP.

• Article · VOLUME 5, ISSUE 2A summary report of the workshop on the ‘academic leadership training in the AIMST University, Malaysia’Subhash J. Bhore · pp. 67–69Case ReportSame type: Article
• Article · VOLUME 5, ISSUE 2Adverse drug reaction profile of anti-snake venom in a rural tertiary care teaching hospitalRushikesh Prabhakar Deshpande, Vijay Motiram Motghare, Sudhir Laxman Padwal, Rakesh Ramkrishna Pore, Chetanraj Ghanshyam Bhamare, Vinod Shivaji Deshmukh, Harshal Nutan Pise · pp. 41–45Same type: Article
• Article · VOLUME 5, ISSUE 2An in silico approach to design potential siRNA molecules for ICP22 (US1) gene silencing of different strains of human herpes simplex 1Suza Mohammad Nur, Mohammad Al Amin, Rashel Alam, Md Anayet Hasan, Md Amzad Hossain, Adnan Mannan · pp. 46–49Same type: Article
• Article · VOLUME 5, ISSUE 2Reasons of using complementary and alternative medicines (CAM) among elderly Malaysians of Kuala Lumpur and Selangor states: An exploratory studyShahid Mitha, Vimalan Nagarajan, Muneer Gohar Babar, Mohammad Jamshed Ahmad Siddiqui, Shazia Qasim Jamshed · pp. 50–53Same type: Article