The Journal of Korean Medicine (대한한의학회지)

The Society of Korean Medicine (대한한의학회)
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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)
  • Received : 2016.05.17
  • Accepted : 2016.06.22
  • Published : 2016.06.30
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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.

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References

  1. Pandit A, Sachdeva T, Bafna P. Drug-Induced Hepatotoxicity: A Review. J Appl Pharma. Science. 2012;2(5):233-43.
  2. 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. https://doi.org/10.1002/hep.20948
  3. Suk KT, Kim DJ. Drug-induced liver injury: present and future. Clin Mol Hepatol. 2012;18(3): 249-57. https://doi.org/10.3350/cmh.2012.18.3.249
  4. 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. https://doi.org/10.1007/s00228-004-0888-z
  5. Ghabril M, Chalasani N, Bjornsson E. Drug-induced liver injury: a clinical update. Curr Opin Gastroenterol. 2010;26(3):222-6. https://doi.org/10.1097/MOG.0b013e3283383c7c
  6. David S, Hamilton JP. Drug-induced Liver Injury. US Gastroenterol Hepatol Rev. 2010;6: 73-80.
  7. World Health Organization. Global Tuberculosis Report 2013. Geneva: World Health Organization, 2013.
  8. Senousy BE, Belal SI, Draganov PV. Hepatotoxic effects of therapies for tuberculosis. Nat Rev Gastroenterol Hepatol. 2010;7(10):543-56. https://doi.org/10.1038/nrgastro.2010.134
  9. 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.
  10. 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. https://doi.org/10.1038/ajg.2012.138
  11. 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.
  12. 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.
  13. 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
  14. Drugs.com. Available at: URL:http://www.drugs.com/sfx/ethambutol-side-effects.html#refs. Accessed May 01, 2016
  15. Drugs.com. Available at: URL:http://www.drugs.com/sfx/rifampin-side-effects.html. Accessed May 01, 2016
  16. Lee JY. Diagnosis and Treatment of Extrapulmonary Tuberculosis. Tuberc Respir Dis. 2015;78(2): 47-55. https://doi.org/10.4046/trd.2015.78.2.47
  17. Park JS. Issues Related to the Updated 2014 Korean Guidelines for Tuberculosis. Tuberc Respir Dis. 2016;79(1):1-4. https://doi.org/10.4046/trd.2016.79.1.1
  18. 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. https://doi.org/10.1111/j.1472-8206.2008.00566.x
  19. 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. https://doi.org/10.1111/j.1365-2036.2011.04674.x
  20. 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).
  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. https://doi.org/10.1016/j.ijmyco.2015.10.001
  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. https://doi.org/10.1016/j.ijmyco.2015.10.002
  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. https://doi.org/10.4103/2249-4863.154661
  25. Madariaga MG. Drug-related hepatotoxicity. N Engl J Med. 2006;354(20):2191-3. https://doi.org/10.1056/NEJMc060733
  26. 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. https://doi.org/10.1053/j.gastro.2008.09.011
  27. 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.
  28. 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. https://doi.org/10.3904/kjim.2016.31.1.65
  29. Ramappa V, Aithal GP. Hepatotoxicity Related to Anti-tuberculosis Drugs: Mechanisms and Management. J Clin Exp Hepatol. 2013;3(1): 37-49. https://doi.org/10.1016/j.jceh.2012.12.001
  30. 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. https://doi.org/10.1053/j.gastro.2008.09.011
  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. https://doi.org/10.1002/hep.21424
  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. https://doi.org/10.1038/ajg.2012.138
  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.

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