title: Liver enzyme abnormalities during concurrent use of herbal and conventional medicines in Korea: a retrospective study.
abstract: Concurrent use of herbal medicine (HM) and conventional medicine (CM) is increasing. However, little is known about the prevalence of drug-induced liver injury (DILI) related to this concurrent use. In order to investigate changes in liver enzymes during concurrent use of HM and CM and to assess the prevalence of DILI related to their concurrent use, we screened for liver injury among inpatients at our institution who were administered both HM and CM for at least 14 days while hospitalized between 2006 and 2010. We used the Council for International Organization of Medical Science (CIOMS) laboratory criteria to define liver injury. Of the 892 patients included in the study, 34 (3.81%) had liver injury on admission and 21 (2.35%) had liver injury at discharge. Of the 48 cases that fulfilled the CIOMS laboratory criteria for liver injury, 34 had preexisting liver injury. The remaining 14 were analyzed, and five were concluded to have DILI, resulting in a prevalence of 5/892 (0.56%, with a 95% confidence interval of 0.07-1.05%). Overall, clinical symptoms of liver injury were mild. We thus contend that concurrent use of HM and CM is relatively safe.
authors.affiliation: Department of Cardiovascular & Neurologic Diseases, College of Oriental Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Na-Hee
authors.initials: NH
authors.lastname: Kim
authors.forename: Hwan-Yong
authors.initials: HY
authors.lastname: Jung
authors.forename: Seung-Yeon
authors.initials: SY
authors.lastname: Cho
authors.forename: Seong-Uk
authors.initials: SU
authors.lastname: Park
authors.forename: Jung-Mi
authors.initials: JM
authors.lastname: Park
authors.forename: Chang-Nam
authors.initials: CN
authors.lastname: Ko
mesh_terms: D000368:Aged; D000410:Alanine Transaminase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis* / Q000201:enzymology* / Q000453:epidemiology; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D041743:Herb-Drug Interactions; D006760:Hospitalization; D006801:Humans; D008099:Liver / Q000187:drug effects* / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000008:administration & dosage / Q000378:metabolism*; D010865:Pilot Projects; D010946:Plants, Medicinal / Q000009:adverse effects / Q000378:metabolism*; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies
chemical_list: D004364:Pharmaceutical Preparations; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase