Athletes and bodybuilders risk using unknown or unregulated substances without medical advice that can harm them through mechanisms not well understood. Among these are "drug cocktails" such as the multiple AAS, clenbuterol, and growth hormone regimen that appears to have caused acute pancreatitis in our patient. Since this is the first case report on the potential toxicity of fluoxymesterone, mesterolone, drostanolone propionate, stanozolol, testosterone enanthate, testosterone propionate, and clenbuterol to the pancreas, we stress that further research is required to understand the mechanism of this combination of drugs in causing DIAP. Users must be aware of the potentially dangerous side effects of uncontrolled consumption and purchasing of such supplements and medications from unknown suppliers, and clinicians should be alert to the possibility of drug-induced pancreatitis in bodybuilders and other athletes.
DIAP: Drug-induced acute pancreatitis; CT: Computed tomography; ERCP: Endoscopic retrograde cholangiopancreatography; PED: Performance-enhancing drugs; WBC: White blood cell count; CRP: C-reactive protein; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; AP: Alkaline phosphatase; CPK: Creatine protein kinase; GGT : Gamma glutamyl transferase; LDH: Lactate dehydrogenase; CK: Creatine kinase.
We gratefully acknowledge the medical education department of Mediclinic Middle East and Al Maktoum Medical Library for their support of the study and literature search, respectively.
This research was supported by the MBRU publication fund of the Mohammed Bin Rashid University of Medicine and Health Sciences.
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Ethics approval and consent to participate
The study was approved by the Mediclinic Middle East IRB, and written consent from the patient was obtained.
Consent for publication
Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
J Med Case Reports. 2022;16(114) © 2022 BioMed Central, Ltd.