Hepatitis Secondary to an Over-the-Counter Appetite Stimulant: A Case Report

We present the case of a previously healthy 11-year-old boy who developed hepatitis in the setting of regular intake of Apetamin. Apetamin is an appetite stimulant not approved by the United States Food and Drug Administration that contains cyproheptadine, lysine, and multiple B vitamins. It is illegally imported into the United States and can be purchased online. The patient was referred to the gastrointestinal clinic for evaluation of hepatitis based on screening laboratory testing collected during a routine healthcare visit. Laboratory workup revealed elevated transaminases six months after beginning Apetamin and positive anti-smooth muscle antibody. Liver enzymes improved following the discontinuation of Apetamin. The case highlights the potential of dietary supplements to cause hepatic injury and the importance of a thorough history of complementary alternative medication usage.