Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)
- Volume 6 Issue 2
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- Pages.110-116
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- 2008
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- 1738-1320(pISSN)
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- 2508-6332(eISSN)
Liver Transplantation for Acute Toxic Hepatitis due to Herbal Medicines and Preparations
식물 제제와 연관된 급성 독성 간염으로 인한 간이식 : 원인 제제와 손상 유형에 대한 후향적 분석
- Sohn, Chang-Hwan (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
- Cha, Myung-Il (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
- Oh, Bum-Jin (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
- Yeo, Woon-Hyung (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
- Lee, Jae-Ho (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
- Kim, Won (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
- Lim, Kyoung-Soo (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center)
- 손창환 (울산대학교 의과대학 서울아산병원 응급의학과) ;
- 차명일 (울산대학교 의과대학 서울아산병원 응급의학과) ;
- 오범진 (울산대학교 의과대학 서울아산병원 응급의학과) ;
- 여운형 (울산대학교 의과대학 서울아산병원 응급의학과) ;
- 이재호 (울산대학교 의과대학 서울아산병원 응급의학과) ;
- 김원 (울산대학교 의과대학 서울아산병원 응급의학과) ;
- 임경수 (울산대학교 의과대학 서울아산병원 응급의학과)
- Published : 2008.12.31
Abstract
Purpose: Acute toxic hepatitis is a common cause of acute liver failure (ALF). We investigated the causes, clinical manifestation, and outcomes of ALF patients who underwent liver transplantation due to acute toxic hepatitis caused by herbal medicines and preparations. Methods: Between January 1992 and May 2008, we retrospectively reviewed the medical records of 24 patients who were transplanted due to acute toxic hepatitis caused by herbal medicines and preparations. We applied the RUCAM score to patients with acute toxic hepatitis and assessed the relationship between herbal preparations and liver injury. We studied the patients' medication history, liver function tests, and clinical outcomes. Results: The type of liver injury was divided into three groups: hepatocellular type, 14 patients (58.3%); cholestatic type, 4 patients (16.7%); and mixed type, 6 patients (25%). Polygonum multiflorum Thunberg (3 cases) was the most common cause of acute toxic hepatitis, followed by Acanthopanax senticosus (2 cases), pumpkin juice (2 cases), Dictamnus dasycarpus Turcz (2 cases), Hovenia dulcis (1 case), Phellinus linteus (1 case), and Artemisia capillaries (1 case). One year survival after liver transplantation was 76%. Conclusion: We identified the herbal preparations leading to acute liver failure. Many patients consider herbal remedies to be completely free of unwanted side effects. However, we found that many herbal products have biological activities that can lead to severe hepatotoxicity.