Korean J Gastroenterol.  2013 Nov;62(5):306-309. 10.4166/kjg.2013.62.5.306.

A Case of Acute Pancreatitis and Acute Hepatitis Caused by Ingestion of Ceramium kondoi

• Kim DB
• Cho YK
• Song HJ
• Song BC

• KMID: 1775740
• DOI: http://doi.org/10.4166/kjg.2013.62.5.306

Abstract

In Korea, the use of herbal remedies is a common cause of drug-induced liver injury. However, the occurrence of both acute pancreatitis and acute hepatitis after taking herbal remedies has rarely been reported. Herein, we report a case of concurrent acute pancreatitis and acute hepatitis associated with Ceramium kondoi ingestion. A 58-year-old woman was diagnosed with advanced gastric cancer 7 months ago. Total gastrectomy and adjuvant chemotherapy was performed without complications. The patient had been well until recently, when she presented with severe abdominal pain after ingestion of Ceramium kondoi for 4 weeks. The laboratory findings demonstrated elevated liver enzymes and lipase, and abdominal computed tomography revealed pancreas swelling with fat infiltration. The diagnosis was made based on the diagnostic criteria for drug induced pancreatitis and the Russel Uclaf Causality Assessment Method scale for drug-induced liver injury. After cessation of Ceramium kondoi, she showed clinical and biochemical improvement.

Keyword

Drug-induced liver injury; Pancreatitis; Herbal remedies

MeSH Terms

Abdominal Pain/etiology
Acute Disease
Drug-Induced Liver Injury/*diagnosis/enzymology
Female
Humans
Lipase/metabolism
Liver/*drug effects
Middle Aged
Pancreas/*drug effects
Pancreatitis/*chemically induced/*diagnosis
Plant Extracts/chemistry/*toxicity
Rhodophyta/chemistry/metabolism
Tomography, X-Ray Computed
Lipase
Plant Extracts

Figure

• 

  Fig. 1. Abdominal computed tomography. (A) Enlarged uncinate process with irregular low density from edema was noted (arrow). (B) Peripancreatic fat linear strands could also be seen (arrow). (C) Gallbladder distension (arrow) and focal wall thickening (arrow head) were demonstrated on coronal image.

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