Clinical features of 28 acutely toxic hepatitis patients who ingested Dictamnus dasycarpus: A single center clinical experience.
- Author:
Jae Hoon JUNG
1
;
Seok Hyun KIM
;
Kwang Hun KO
;
Kyoung Hye JUNG
;
Se Woong HWANG
;
Pyong Gohn GOH
;
Nam Hwan PARK
;
Gwan Woo NAM
;
Jeong IL KIM
;
Hee Seok MOON
;
Eaum Seok LEE
;
Jae Kyu SUNG
;
Byung Seok LEE
;
Heon Young LEE
;
Dae Young KANG
Author Information
1. Department of Internal Medicine, Gongju Medical Center, Gongju, Korea.
- Publication Type:Original Article
- Keywords:
Dictamnus dasycarpus;
Toxic hepatitis;
Pure red cell aplasia
- MeSH:
Abdominal Pain;
Anorexia;
Ascites;
Cytomegalovirus;
Dictamnus;
Drug-Induced Liver Injury;
Edema;
Fatigue;
Fatty Liver;
Female;
Hepatitis;
Hepatitis A;
Herpesvirus 4, Human;
Hospitalization;
Humans;
Incidence;
Jaundice;
Liver;
Lymphatic Diseases;
Medical Records;
Muscles;
Nausea;
Red-Cell Aplasia, Pure;
Retrospective Studies;
Splenomegaly;
Urinary Bladder
- From:Korean Journal of Medicine
2010;78(4):457-465
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The aim of this study was to investigate the clinical features of acutely toxic hepatitis associated with ingesting Dictamnus dasycarpus (D. dasycarpus). METHODS: Between January 2004 and July 2009, 28 patients were enrolled in this study. We reviewed the medical records retrospectively. Acutely toxic hepatitis associated with D. dasycarpus was diagnosed by a Roussel Uclaf Causality Assessment Method Values (RUCAM) score of 6 or above. All patients were tested for viral hepatitis A, B, C, cytomegalovirus, and Epstein-Barr virus. Other tests included anti-nuclear antibody, anti-mitochondrial antibody, and anti-smooth muscle antibody. Abdominal pelvic computed tomography was performed. RESULTS: The incidence was female predominant (64% vs. 36%). The mean patient age was 53.0+/-11 years. The symptoms were jaundice (68%), fatigue (57%), nausea (43%), anorexia (43%), and abdominal pain (24%). The mean RUCAM score was 7.0+/-0.8. The biochemical patterns of hepatotoxicity were hepatocellular (n=23, 82%) and mixed types (n=5, 18%). Radiologic findings were as follows: normal findings (29%), lymphadenopathy (50%), edema of the gall bladder wall (46%), periportal edema (43%), splenomegaly (11%), fatty liver (11%), and ascites (7%). The mean hospitalization period was 21.6+/-11.6 days. The mean duration of recovery from hepatitis was 56.6+/-30.4 days, and all patients recovered completely from the toxic hepatitis. One patient who had severe jaundice developed a complication of pure red cell aplasia during the hospitalization period. CONCLUSIONS: The biochemical pattern of liver injury was hepatocellular predominant. Although the initial manifestations and clinical course were variable, all patients completely recovered with supportive care or steroid treatment. Toxic hepatitis was accompanied by pure red cell aplasia in one patient.
