Gut Liver.  2011 Dec;5(4):493-499.

Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb

• Jung KA
• Min HJ
• Yoo SS
• Kim HJ
• Choi SN
• Ha CY
• Kim HJ
• Kim TH
• Jung WT
• Lee OJ
• Lee JS
• Shim SG

Abstract

BACKGROUND/AIMS
Complementary medicines, including herbal preparations and nutritional supplements, are widely used without prescriptions. As a result, there has been growing interest in the risk of hepatotoxicity with these agents. It is difficult to determine causal relationships between these herbal preparations and hepatotoxicity. We report on 25 patients diagnosed with toxic hepatitis following ingestion of Polygonum multiflorum Thunb.
METHODS
Twenty-five patients (median age, 48 years [24 to 65 years]; M:F=18:7) with suspected P. multiflorum Thunb-induced liver injury were admitted to our hospital between 2007 and 2009. We analyzed clinical and histological data, including the types and the duration of P. multiflorum Thunb intake and the duration of hospital care. We also determined the type of liver injury using the R ratio (serum activity of ALT/serum activity of ALP).
RESULTS
The types of complementary medicine used included tea (n=16), liquor (n=5), tea and liquor (n=2), powder (n=1), and honeyed pudding (n=1). The most common presenting sign was jaundice (76%), and 18 patients (72%) had evidence of hepatocellular liver injury. Histological findings were consistent with acute hepatitis in all cases (n=10) for which liver biopsy was performed. Twenty-three patients (91.6%) recovered with conservative management, 1 patient (4%) had a liver transplant, and 1 patient (4%) died of hepatic failure.
CONCLUSIONS
In our cases, we found that P. multiflorum Thunb could be hepatotoxic and could lead to severe drug-induced liver injury, and even death.

Keyword

Drug induced liver injury; Polygonum multiflorum Thunb; Hepatotoxicity

MeSH Terms

Biopsy
Complementary Therapies
Drug-Induced Liver Injury
Eating
Hepatitis
Humans
Jaundice
Liver
Plant Preparations
Polygonum
Prescriptions
Tea
Transplants
Plant Preparations
Tea