Is green tea a potential trigger for autoimmune hepatitis?
A case of autoimmune liver hepatitis is reported: the onset was triggered by consumption of green tea infusion in a patient taking oral contraceptives and irbesartan. We hypothesize that our patient, carrying genetic variant of hepatic metabolism making her particularly susceptible to oxidative stress, developed an abnormal response to a mild toxic insult, afforded by a combination of agents (oral contraceptives+irbesartan+green tea) that normally would not be able to cause damage. Her particular hepatic metabolism further increased the drugs' concentration, favoring the haptenization of liver proteins, eventually leading to the development of an autoimmune hepatitis.
University of Florence, Department of Neuroscience, Psychology, Drug Research and Child Health (NeuroFarBa), Center of Molecular Medicine (CIMMBA), Florence, Italy.
Eugenia
E
Gallo
Valentina
V
Maggini
Margherita
M
Berardi
Alessandra
A
Pugi
Rosario
R
Notaro
Giulia
G
Talini
Giancarlo
G
Vannozzi
Siro
S
Bagnoli
Paolo
P
Forte
Alessandro
A
Mugelli
Vito
V
Annese
Fabio
F
Firenzuoli
Alfredo
A
Vannacci
D000328:Adult; D001713:Biphenyl Compounds / Q000009:adverse effects*; D003276:Contraceptives, Oral / Q000009:adverse effects*; D005260:Female; D019693:Hepatitis, Autoimmune / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics*; D006801:Humans; D000077405:Irbesartan; D008099:Liver / Q000187:drug effects; D018384:Oxidative Stress; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D013662:Tea / Q000009:adverse effects*; D013777:Tetrazoles / Q000009:adverse effects*
D001713:Biphenyl Compounds; D003276:Contraceptives, Oral; D013662:Tea; D013777:Tetrazoles; D000077405:Irbesartan
AIH; ALT; AP; Autoimmune hepatitis; CYP; Catechin; EGCG; GGT; GST; Green tea; MDR; MTHFR; SULT; Single nucleotide polymorphism; UDP glucuronosyltransferase; UGT; alanine aminotransferase; alkaline phosphatase; autoimmune like hepatitis; cytochrome P450; epigallocatechin-3-gallate; glutamiltransferase; glutathione S-transferase; methylenetetrahydrofolate reductase; multidrug resistance; sulfotransferase