title: Acute hepatitis induced by a Chinese herbal product Qibao Meiran Wan: a case study.
abstract: Qibao Meiran Wan is a Chinese herbal product sold as a therapy for tonifying the liver and kidney, dizziness, premature graying of hair, backache, constipation, and night sweats. It is widely available in Chinese pharmacies and drugstores and is sold without prescription. We describe a case of acute liver injury in a 26-year-old Chinese man who developed symptomatic hepatitis 1 month after starting Qibao Meiran Wan. There was no evidence of viral hepatitis, Epstein-Barr virus, cytomegalovirus, autoimmune hepatitis, or Budd-Chiari syndrome. The liver injury slowly resolved over 20 days after discontinuing the herbal product. Herbal toxicity was later confirmed by a liver biopsy. Qibao Meiran Wan contains a mixture of several plants including Polygonum multiflorum, which was previously associated with hepatotoxicity. To our knowledge, this is the first report of hepatotoxicity by Qibao Meiran Wan. Clinicians treating patients with acute hepatitis of unclear etiology should pay attention to the consumption of Qibao Meiran Wan.
authors.affiliation: Department of Clinical Pharmacology, The Sixth Affiliated Hospital of Sun Yat-Sen University 26 Yuancun Erheng Rd, Guangzhou 510655, Guangdong, China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Clinical Pharmacology, The Third Affiliated Hospital of Sun Yat-Sen University 600 Tianhe Rd, Guangzhou 510630, Guangdong, China.
authors.forename: Caihong
authors.initials: C
authors.lastname: Qu
authors.affiliation: Department of Pathology, The First Affiliated Hospital of Sun Yat-Sen University 74 Zhongshan 2 Rd, Guangzhou 510080, Guangdong, China.
authors.forename: Qiong
authors.initials: Q
authors.lastname: He
authors.affiliation: Department of Clinical Pharmacology, Guangdong General Hospital 106 Zhongshan 2 Rd, Guangzhou 510085, Guangdong, China.
authors.forename: Wenying
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Clinical Pharmacology, Guangdong General Hospital 106 Zhongshan 2 Rd, Guangzhou 510085, Guangdong, China.
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Clinical Pharmacology, Guangdong General Hospital 106 Zhongshan 2 Rd, Guangzhou 510085, Guangdong, China.
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Clinical Pharmacology, The Third Affiliated Hospital of Sun Yat-Sen University 600 Tianhe Rd, Guangzhou 510630, Guangdong, China.
authors.forename: Yuxing
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Pharmacology, Cardiac and Cerebral Vascular Research Center, Zhongshan School of Medicine, Sun Yat-Sen University 74 Zhongshan 2 Rd, Guangzhou 510080, Guangdong, China.
authors.forename: Yongbo
authors.initials: Y
authors.lastname: Tang
keywords: Drug-induced liver injury; Qibao Meiran Wan; adverse drug reaction; hepatotoxicity