title: [Liver injury and hepatic encephalopathy induced by the herbal medicine Hochuekkito].
abstract: A 57-year-old man was admitted with pruritus and jaundice following treatment for fatigue with the herbal medicine Hochuekkito. The patient was prescribed prednisolone and ursodeoxycholic acid, but he developed progressive cholestasis that required intravenous methylprednisolone pulse therapy. After treatment with plasma exchange for prolonged prothrombin time, the patient recovered; however, his liver function deteriorated because of liver injury induced by trimethoprim-sulfamethoxazole for pneumocystis pneumonia. After reduction of trimethoprim-sulfamethoxazole, his liver function almost returned to normal by day 130 of admission. It has remained normal for 10 months since then. Therefore, when prescribing Hochuekkito, the possibility of drug-induced liver injury should be taken in account.
authors.affiliation: Department of Gastroenterology, Itabashi Chuo Medical Center.
authors.forename: Ryoju
authors.initials: R
authors.lastname: Negishi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Tawa
authors.forename: Akira
authors.initials: A
authors.lastname: Fujimura
authors.forename: Sayo
authors.initials: S
authors.lastname: Tanaka
authors.forename: Akira
authors.initials: A
authors.lastname: Tenmoku
authors.forename: Kimika
authors.initials: K
authors.lastname: Akazawa
authors.forename: Masataka
authors.initials: M
authors.lastname: Kanno
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sasaki
authors.forename: Sae
authors.initials: S
authors.lastname: Okubo
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Machida
authors.forename: Yuh
authors.initials: Y
authors.lastname: Fukuda
authors.forename: Itaru
authors.initials: I
authors.lastname: Oi
authors.forename: Masayuki A
authors.initials: MA
authors.lastname: Fujino
mesh_terms: D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D004365:Drugs, Chinese Herbal; D006501:Hepatic Encephalopathy / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010936:Plant Extracts / Q000009:adverse effects*
chemical_list: D004365:Drugs, Chinese Herbal; D010936:Plant Extracts; C402943:bu-zhong-yi-qi-tang