Herbal drug-induced fulminant hepatitis

Abstract

A case of fulminant hepatitis due to a herbal drug was reported. A 62-year-old male was admitted to Iwate Medical University Hospital because of jaundice and malaise after taking a herbal drug (Kinshigan) containing 17 herbal medicines for five weeks. He had a previous history of jaundice following Kinshigan intake. On admission, prothrombin time was prolonged (28%) and CT scan revealed markedly atrophic liver. Viral markers were negative for hepatitis A, B and C. Despite of intensive therapies including plasmapheresis, he died from hepatic coma with multiple organ failure after 4 weeks. The liver weighed 495 g, showing the histological features of massive hepatic necrosis. Nine cases of Kinshigan-induced hepatic injury have been reported to date. It was noteworthy, presumably due to the preconception that herbal medicine is safer than western drugs, that the patients tended to have multiple episodes of hepatitis following repeated intake of the drug. © 1991, The Japan Society of Hepatology. All rights reserved.