• The Journal of Pediatrics of Korean Medicine
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• v.22 no.3
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• pp.83-94
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• 2008

Objectives : The purpose of this study is to confirm severe problem caused by using a modified RUCAM scale than that officially recognized to diagnose liver injury induced by herbal medicine. Materials and Methods : Cases with liver injury induced by herbal medicine received to a related institute from January 2004 to December 2007 were collected and evaluated by the original scale and modified scale. Results : 1. Based on this study, we couldn't clinicaly confirm that the case was not excluded by the relieved first item basis of modified RUCAM scale which has to be excluded by the first item basis of orginal RUCAM scale. 2. By modified 6th item, one score was added to the total score. 3. By adding 8th item, it gaind one point to the whole the total score. Conclusions : In this study, we can clinically confirm that the modified RUCAM　application to case with liver injury induced by herbal medicine is a severe problem.

• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1035-1042
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• 2019

Background: Herbal medication is widely used in the Korean Medicine Hospital, and drug-induced liver injury (DILI) in Korea has increased proportionally. Herb-induced liver injury now accounts for approximately 40% of cases of hepatotoxicity in Korea, according to research data. Currently, however, the component responsible for the toxicity is usually unknown or can only be suspected. Objective: To study the hepatotoxicity of Cheongsimyeonja-tang in DILI. Methods: A retrospective review was conducted of 82 inpatients between April 2010 and March 2017 with suspected drug-induced liver injury (n=5). The standard criteria (RUCAM scale) for drug-induced liver injury (DILI) were applied. The electronic medical records (EMRs) were retrospectively reviewed to identify the relevant database. Aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bilirubin (T. Bili) were analyzed in blood samples before and after the administration of Cheongsimyeonja-tang. Results: Five cases out of 82 patients had a criterion-referenced probable (RUCAM) score ranging from 6 to 8 points DILI. However, statistical analysis of the liver function parameters results of the 82 patients did not show a statistically meaningful elevation after taking Cheongsimyeonja-tang. Conclusions: These data suggest a relationship between Cheongsimyeonja-tang and DILI. More studies are needed to validate these observations and to explore their implications.

• Journal of Sasang Constitutional Medicine
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• v.21 no.3
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• pp.209-215
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• 2009

1. Objects: This case study reports a liver injury in treatment of constipation with Yeoldahanso-tang plus Rheum rhabarbarum. 2. Methods: The patient's subjective symptoms and the laboratory data including aspartate transaminase(AST), alanine transaminase(ALT), alkaline phosphatase(ALP), and gamma($\gamma$)-glutamyl transpeptidase(GGT) were observed before and after liver injury. We used the Roussel Uclaf Causality Assessment Method(RUCAM) scale in order to find out whether if Yeoldahanso-tang plus Rheum rhabarbarum was related with the liver injury. 3. Results: The patient's AST and ALT were elevated more than twice after a 3week administration period of herbal medicine. After discontinuation of the herbal medicine and administration of hepatic protective medication, AST and ALT decreased. The patient's general condition improved during hospitalization. The RUCAM score was estimated at 8. 4. Conclusions: This case is presented to bring more attention to the toxicity of herbal medicine.

• Journal of Food Hygiene and Safety
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• v.26 no.4
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• pp.302-307
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• 2011

One of the most important objectives of post-marketing monitoring of dietary supplements is the early detection of unknown and unexpected adverse events (AEs). Several causality algorithms, such as the Naranjo scale, the RUCAM scale, and the M & V scale are available for the estimation of the likelihood of causation between a product and an AE. Based on the existing algorithms, the Korea Food & Drug Administration has developed a new algorithm tool to reflect the characteristics of dietary supplements in the causality analysis. However, additional work will be required to confirm if the newly developed algorithm tool has reasonable sensitivity and not to generate an unacceptable number of false positives signals.

• Journal of Haehwa Medicine
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• v.18 no.1
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• pp.83-88
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• 2009

Recently, herbal drugs haver been used world wide. and generally regarded as safe with no serious adverse reaction. Drug-induced liver injury (DILI) is one of frequent cause of liver diseases. If DILI is not treated, it can be developed into liver cirrhosis, hepatoma, etc. Currently, DILI has been reported to be common cause of acute hepatitis, and oriental medicine and folk remedy are not exception. We encountered one case of DILI, cause by folk remedy. Patients complained chest discomfort, yellow skin and urine, nausea, vomiting. Lab test showed elevated level of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transpeptidase (r-GTP), total bilirubin (TB). We estimated acute DILI and stopped taking folk medication made by himself. After 1 week of treatment, the clinical symptoms and liver function improved. Genetic and environmental factors as well as drug itself decide the hepatic toxicity, and the major DILI are belonged in acute type. So we need to get more attention to folk medication to help preventing the DILI cause by folk remedy.