title: Drug-induced acute liver injury mimicking autoimmune hepatitis after intake of dietary supplements containing glucosamine and chondroitin sulfate.
abstract: BACKGROUND
  Herbal and dietary supplements are widely used as measures to improve and preserve health and well-being. Among the bestselling preparations are dietary supplement containing glucosamine and chondroitine sulfate taken to improve symptoms of osteoarthritis.
  
  
  RESULTS
  We here present a case of a male patient with biopsy-proven acute and severe autoimmune hepatitis subsequent to intake of a preparation containing glucosamine and chondroitine sulfate. Response to steroids was favorable and resulted in complete remission of the patient. Diagnostic work-up of the case revealed no other possible cause of liver injury, and causality assessment using the Roussel Uclaf Causality Assessment Method (RUCAM) resulted in a possible causal relationship between intake of glucosamine and chondroitine sulfate and the adverse hepatic reaction.
  
  
  CONCLUSIONS
  The present case recalls that products containing glucosamine and chondroitine sulfate can occasionally cause acute liver injury mimicking autoimmune hepatitis, and reminds of the potential dangers of compounds with poor efficacy and ill-defined safety records.
authors: Department of Visceral Surgery and Medicine, University of Berne, Switzerland.
authors: Johann
authors: J
authors: von Felden
authors: Matteo
authors: M
authors: Montani
authors: Kerstin
authors: K
authors: Kessebohm
authors: Felix
authors: F
authors: Stickel
mesh_terms: D000208:Acute Disease; D000368:Aged; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D002809:Chondroitin Sulfates / Q000009:adverse effects*; D003937:Diagnosis, Differential; D019587:Dietary Supplements / Q000009:adverse effects*; D005944:Glucosamine / Q000009:adverse effects*; D019693:Hepatitis, Autoimmune / Q000209:etiology*; D006801:Humans; D008297:Male
chemical_list: D002809:Chondroitin Sulfates; D005944:Glucosamine