Unique Case of Acute Pancreatitis Linked to L-Arginine Supplement Use In A Bodybuilder

The two most common etiologies of acute pancreatitis are alcohol abuse and gallstones which comprise greater than 80% of all cases. There are many other possible etiologies, including hypertriglyceridemia, trauma, ischemia, autoimmune, drugs such as anabolic steroids and toxins such as scorpion venom. We report a unique case of acute pancreatitis in a 34-year-old body-builder related to use of the L-arginine protein product. The patient denied any alcohol use or any use of anabolic steroids for bodybuilding. He had a past medical history of bipolar disorder treated with valproic acid but had no longer been taking this medication for the past 8 months and had never complained of epigastric pain like this in the past. With the most common etiologies of his presentation being ruled out, it was discovered that he had been taking the L-arginine protein product which has been shown in multiple mouse studies to lead to development of acute pancreatitis. Although the mechanism of L-arginine pancreatitis is not clear, awareness should be raised with the increase of the consumption of supplements among young adults.