[Drug-induced toxic hepatitis].
A 55-year-old male patient was hospitalized with severe nausea, vomiting and icterus. Laboratory testing showed hepatocellular damage. After exhaustive testing, the exclusion diagnosis of a toxic hepatitis was reached. There was a strong temporal correlation with the ingestion of Hong Hua 29, a preparation from Traditional Chinese Medicine (TCM). This medication had been started twelve days prior to the first appearance of symptoms. The existing drug regimen included gabapentin (Neurontin), esomeprazole (Nexium) and prednisone (Prednison Streuli) for the therapy of an acute sensory and motor neuropathy of unknown aetiology. After cessation of Hong Hua 29, gabapentin and esomeprazole, transaminase levels started to declined and normalized within three months. According to the Swissmedic criteria of imputability, a causal correlation between the observed symptoms and the administration of Hong Hua 29 is possible.
Klinische Pharmakologie & Toxikologie, Universititsspital Basel. oliver.kummer@unibas.ch
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Kummer
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Hammann
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Bodmer
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Novakova
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Krähenbühl
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Haschke
D001706:Biopsy; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology* / Q000473:pathology; D002780:Cholestasis, Intrahepatic / Q000139:chemically induced / Q000175:diagnosis / Q000473:pathology; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use / Q000633:toxicity*; D006801:Humans; D007764:Lacquer / Q000633:toxicity*; D008099:Liver / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009443:Neuritis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology
D004365:Drugs, Chinese Herbal; C530356:Hong Hua 29