title: SlimQuick™ - associated hepatotoxicity in a woman with alpha-1 antitrypsin heterozygosity.
abstract: Green tea (Camellia sinensis)-associated hepatotoxicity is reported. However, the presence of alpha-1 antitrypsin MZ phenotype as a predisposing factor to green tea-associated drug-induced liver injury (DILI) is unknown. A previously healthy woman with alpha-1 antitrypsin MZ phenotype who took SlimQuick™, an herbal supplement containing green tea extract, developed severe hepatotoxicity requiring corticosteroid treatment. Green tea-associated hepatotoxicity is reviewed and alpha-1 antitrypsin MZ phenotype as a predisposing factor to green tea-associated DILI is discussed. Liver biopsy demonstrated marked inflammation with necrosis suggestive of toxic injury with diffuse alpha-1 antitrypsin globule deposition on immunostaining. Corticosteroid therapy resulted in rapid clinical improvement. Alpha-1 antitrypsin MZ phenotype may increase vulnerability to herbal hepatotoxicity.
authors.affiliation: Douglas H Weinstein, Jean-Pierre Raufman, Ayse L Mindikoglu, Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, United States.
authors.forename: Douglas H
authors.initials: DH
authors.lastname: Weinstein
authors.forename: William S
authors.initials: WS
authors.lastname: Twaddell
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Raufman
authors.forename: Benjamin
authors.initials: B
authors.lastname: Philosophe
authors.forename: Ayse L
authors.initials: AL
authors.lastname: Mindikoglu