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http://dx.doi.org/10.13048/jkm.16028

A Severe Hepatotoxicity by Antituberculosis Drug, and its Recovery in Oriental Hospital  

Son, Chang-Gue (Liver and Immunology Research Center, Oriental Medical College in Daejeon University)
Publication Information
The Journal of Korean Medicine / v.37, no.2, 2016 , pp. 119-124 More about this Journal
Abstract
Objectives: To demonstrate a clinical course and feature of a female patient with a severe liver injury (DILI) during antituberculosis treatment for her intestinal tuberculosis, whom traditional Korean medicine completely recovered. Methods: A female patient with diagnosed as DILI by antituberculosis drugs had been treated with herbal drugs; and then the clinical outcome and biochemical parameters had been monitored. Result: A 45-year old female had taken antituberculosis drugs for about 2 months, and complained severe abdominal discomfort and dyspepsia. The RUCAM score was 10, which met the criteria for DILI (AST 584 IU/L, ALT 1212 IU/L, ALP 100 IU/L, and GGT 161 IU/L, total bilirubin 0.9 mg/dL). She had been treated with herbal drugs and acupuncture as inpatient and outpatient, and then her symptoms had been completely recovered with normalization of hepatic enzymes. Conclusion: This report provides a clinical characteristic for a severe hepatotoxicity induced by antituberculosis drugs, and showed an example of TKM-based application.
Keywords
Antituberculosis drug; Drug-induced liver injury; Traditional Korean medicine; Herbal medicine;
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Times Cited By KSCI : 7  (Citation Analysis)
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1 David S, Hamilton JP. Drug-induced Liver Injury. US Gastroenterol Hepatol Rev. 2010;6: 73-80.
2 World Health Organization. Global Tuberculosis Report 2013. Geneva: World Health Organization, 2013.
3 Senousy BE, Belal SI, Draganov PV. Hepatotoxic effects of therapies for tuberculosis. Nat Rev Gastroenterol Hepatol. 2010;7(10):543-56.   DOI
4 Suk KT, Kim DJ, Kim CH, Park SH, Yoon JH, Kim YS, et al. A prospective nationwide study of drug-induced liver injury in Korea. Am J Gastroenterol. 2012;107(9):1380-7.   DOI
5 Seo JC, Jeon WJ, Park SS, Kim SH, Lee KM, Chae HB, et al. Clinical experience of 48 acute toxic hepatitis patients. Korean J Hepatol. 2006;12(1):74-81.
6 Suk KT, Kim DJ. Drug-induced liver injury: present and future. Clin Mol Hepatol. 2012;18(3): 249-57.   DOI
7 Meier Y, Cavallaro M, Roos M, Pauli-Magnus C, Folkers G, Meier PJ, et al. Incidence of drug-induced liver injury in medical inpatients. Eur J Clin Pharmacol. 2005;61(2):135-43.   DOI
8 Ghabril M, Chalasani N, Bjornsson E. Drug-induced liver injury: a clinical update. Curr Opin Gastroenterol. 2010;26(3):222-6.   DOI
9 Chun WJ, Yoon BG, Kim NI, Lee G, Yang CH, Lee CW, et al. A clinical study of patients with acute liver injury caused by herbal medication in Gyeongju area. Korean J Med. 2002;63(2):141-50.
10 U.S. National Library of Medicine. Available at: URL:https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682401.html#side-effec. Accessed May 10, 2016
11 Lee JY. Diagnosis and Treatment of Extrapulmonary Tuberculosis. Tuberc Respir Dis. 2015;78(2): 47-55.   DOI
12 Drugs.com. Available at: URL:http://www.drugs.com/sfx/ethambutol-side-effects.html#refs. Accessed May 01, 2016
13 Sun Q, Zhang Q, Gu J, Sun WW, Wang P, Bai C, et al. Prevalence, risk factors, management, and treatment outcomes of first-line antituberculous drug-induced liver injury: a prospective cohort study. Pharmacoepidemiol Drug Saf. 2016. doi: 10.1002/pds.3988. Ahead of print.   DOI
14 Drugs.com. Available at: URL:http://www.drugs.com/sfx/rifampin-side-effects.html. Accessed May 01, 2016
15 Lucena MI, Garcia-Cortes M, Cueto R, Lopez-Duran J, Andrade RJ. Assessment of drug-induced liver injury in clinical practice. Fundam Clin Pharmacol. 2008;22(2):141-58.   DOI
16 Park JS. Issues Related to the Updated 2014 Korean Guidelines for Tuberculosis. Tuberc Respir Dis. 2016;79(1):1-4.   DOI
17 Pandit A, Sachdeva T, Bafna P. Drug-Induced Hepatotoxicity: A Review. J Appl Pharma. Science. 2012;2(5):233-43.
18 Larson AM, Polson J, Fontana RJ, Davern TJ, Lalani E, Hynan LS, et al. Acetaminophen-induced acute liver failure: results of a United States multicenter, prospective study. Hepatology. 2005; 42(6):1364-72.   DOI
19 Saha A, Shanthi FXM, Winston AB, Das S, Kumar A, Michael JS, et al. Prevalence of Hepatotoxicity From Antituberculosis Therapy: A Five-Year Experience From South India. J Prim Care Community Health. 2016;pii: 21501 31916642431(Epub ahead of print).
20 Au JS, Navarro VJ, Rossi S. Review article: Drug-induced liver injury its pathophysiology and evolving diagnostic tools. Aliment Pharmacol Ther. 2011;34(1):11-20.   DOI
21 Isa SE, Ebonyi AO, Shehu NY, Idoko P, Anejo-Okopi JA, Simji G, et al. Antituberculosis drugs and hepatotoxicity among hospitalized patients in Jos, Nigeria. Int J Mycobacteriol. 2016;5(1):21-6.   DOI
22 Wondwossen Abera, Waqtola Cheneke, Gemeda Abebe. Incidence of antituberculosis-drug-induced hepatotoxicity and associated risk factors among tuberculosis patients in Dawro Zone, South Ethiopia: A cohort study. Int J Mycobacteriol. 2016;5(1):14-20.   DOI
23 Center for Disease Control Latent Tuberculosis Infection: A Guide for Primary Health Care Providers. cdc.gov. Retrieved 25 March 2016.
24 Gaude GS, Chaudhury A, Hattiholi J. Drug-induced hepatitis and the risk factors for liver injury in pulmonary tuberculosis patients. J Family Med Prim Care. 2015;4(2):238-43.   DOI
25 Chalasani N, Fontana RJ, Bonkovsky HL, Watkins PB, Davern T, Serrano J, et al. Causes, clinical features, and outcomes from a prospective study of drug-induced liver injury in the United States. Gastroenterology. 2008;135(6):1924-34.   DOI
26 Madariaga MG. Drug-related hepatotoxicity. N Engl J Med. 2006;354(20):2191-3.   DOI
27 Chalasani N, Fontana RJ, Bonkovsky HL, Watkins PB, Davern T, Serrano J, et al. Causes, clinical features, and outcomes from a prospective study of drug-induced liver injury in the United States. Gastroenterology. 2008;135(6):1924-34.   DOI
28 Shigeto E. Committee for Treatment Japanese Society for Tuberculosis. Survey of anti-tuberculosis drug-induced severe liver injury in Japan. Kekkaku. 2007;82(5):467-73.
29 Lee CM, Lee SS, Lee JM, Cho HC, Kim WS, Kim HJ, et al. Early monitoring for detection of antituberculous drug-induced hepatotoxicity. Korean J Intern Med. 2016;31(1):65-72.   DOI
30 Ramappa V, Aithal GP. Hepatotoxicity Related to Anti-tuberculosis Drugs: Mechanisms and Management. J Clin Exp Hepatol. 2013;3(1): 37-49.   DOI
31 Andrade RJ, Lucena MI, Kaplowitz N, Garcia-Munoz B, Borraz Y, Pachkoria K, et al. Outcome of acute idiosyncratic drug-induced liver injury: Long-term follow-up in a hepatotoxicity registry. Hepatology. 2006;44(6):1581-8.   DOI
32 Suk KT, Kim DJ, Kim CH, Park SH, Yoon JH, Kim YS, et al. A prospective nationwide study of drug-induced liver injury in Korea. Am J Gastroenterol. 2012;107(9):1380-7.   DOI
33 Park HM, Jang IS, Lee SD. Hepatotoxic Events Associated with Herbal Medicinal Products, Folk Remedies and Food Supplements in Korea. J Korean Oriental Med. 2005;26(2):152-65.