1.A Case of Acute Pancreatitis and Acute Hepatitis Caused by Ingestion of Ceramium kondoi.
Da Bin KIM ; Yoo Kyung CHO ; Hyun Joo SONG ; Byung Cheol SONG
The Korean Journal of Gastroenterology 2013;62(5):306-309
In Korea, the use of herbal remedies is a common cause of drug-induced liver injury. However, the occurrence of both acute pancreatitis and acute hepatitis after taking herbal remedies has rarely been reported. Herein, we report a case of concurrent acute pancreatitis and acute hepatitis associated with Ceramium kondoi ingestion. A 58-year-old woman was diagnosed with advanced gastric cancer 7 months ago. Total gastrectomy and adjuvant chemotherapy was performed without complications. The patient had been well until recently, when she presented with severe abdominal pain after ingestion of Ceramium kondoi for 4 weeks. The laboratory findings demonstrated elevated liver enzymes and lipase, and abdominal computed tomography revealed pancreas swelling with fat infiltration. The diagnosis was made based on the diagnostic criteria for drug induced pancreatitis and the Russel Uclaf Causality Assessment Method scale for drug-induced liver injury. After cessation of Ceramium kondoi, she showed clinical and biochemical improvement.
Abdominal Pain/etiology
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Acute Disease
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Drug-Induced Liver Injury/*diagnosis/enzymology
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Female
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Humans
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Lipase/metabolism
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Liver/*drug effects
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Middle Aged
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Pancreas/*drug effects
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Pancreatitis/*chemically induced/*diagnosis
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Plant Extracts/chemistry/*toxicity
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Rhodophyta/chemistry/metabolism
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Tomography, X-Ray Computed
2.A case of amoxicillin-induced hepatocellular liver injury with bile-duct damage.
Ju Seung KIM ; Young Rock JANG ; Ji Won LEE ; Jin Yong KIM ; Young Kul JUNG ; Dong Hae CHUNG ; Oh Sang KWON ; Yun Soo KIM ; Duck Joo CHOI ; Ju Hyun KIM
The Korean Journal of Hepatology 2011;17(3):229-232
Amoxicillin, an antibiotic that is widely prescribed for various infections, is associated with a very low rate of drug-induced liver injury; hepatitis and cholestasis are rare complications. Here we present a case of a 39-year-old woman who was diagnosed with abdominal actinomycosis and received amoxicillin treatment. The patient displayed hepatocellular and bile-duct injury, in addition to elevated levels of liver enzymes. The patient was diagnosed with amoxicillin-induced cholestatic hepatitis. When amoxicillin was discontinued, the patient's symptoms improved and her liver enzyme levels reduced to near to the normal range.
Actinomycosis/drug therapy
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Adult
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Alanine Transaminase/blood
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Alkaline Phosphatase/blood
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Amoxicillin/*adverse effects
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Anti-Bacterial Agents/*adverse effects
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Aspartate Aminotransferases/blood
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Cholestasis/*chemically induced
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Drug-Induced Liver Injury/*diagnosis/etiology
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Female
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Humans
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Liver/enzymology
3.A Case of Lead Poisoning with Drug-induced Liver Injury after Ingestion of Herbal Medicine.
Gi Jung JEON ; Jongha PARK ; Min Sung KIM ; Jong Won YU ; Jae Hyun PARK ; Min Sik KIM
The Korean Journal of Gastroenterology 2015;65(6):375-378
A 61-year-old male patient was admitted because of unexplained abdominal pain and anemia. His past medical history was unremarkable except for having taken herbal medicine to treat facial palsy two months ago. The result of health examination performed about a month ago showed increased serum aspartate and alanine aminotransferase level, and he was diagnosed with toxic hepatitis by herbal medicine. When the patient presented to the outpatient department three weeks ago, follow-up liver function test results showed improvement but he complained of abdominal pain. Despite extensive blood chemistry tests and computed tomography, the cause of pain could not be found. After much deliberation, serum lead level and herbal medicines analysis was performed based on the fact that he took herbal medicine two months ago, and he could finally be diagnosed with lead poisoning. Since the serum lead level was high enough to be indicated for lead chelating therapy, conservative management was given. When a patient with toxic hepatitis due to herbal medication presents with abdominal pain, the possibility of lead poisoning should always be taken into consideration.
Acute Disease
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Alanine Transaminase/analysis
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Aspartate Aminotransferases/analysis
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Chemical and Drug Induced Liver Injury/*diagnosis
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Hemoglobins/analysis
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Humans
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Lead/analysis
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*Lead Poisoning
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Liver/enzymology/metabolism
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Liver Function Tests
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Male
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Middle Aged
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Plants, Medicinal/chemistry
4.A Case of Nodular Regenerative Hyperplasia of the Liver Combined with Toxic Hepatitis.
Sun Mi JIN ; Sang Hee SONG ; Yang Hyun CHO ; Dae Kyu SHIN ; Sun Young SHIN ; Gwang Il KIM ; Hana PARK ; Kyu Sung RIM
The Korean Journal of Gastroenterology 2015;65(1):52-56
Nodular regenerative hyperplasia (NRH) is an uncommon liver condition characterized by diffuse transformation of the hepatic parenchyma into regenerative nodules without fibrosis. Portal vasculopathy caused by abnormal hepatic venous flow may induce hepatocyte hyperplasia, which forms regenerative nodules. Underlying diseases or certain drugs may also be the cause of NRH. This condition is often underdiagnosed as the patients remain asymptomatic until development of portal hypertension, and histopathologic confirmation by liver biopsy is the only way of making a definite diagnosis. The management mainly involves prevention and treatment of the complications of portal hypertension. The frequency of diagnosis of NRH has increased rapidly in recent years, however, only a few cases have been reported in Korea. Here, we report on a case of NRH of the liver combined with toxic hepatitis.
Alanine Transaminase/analysis
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Aspartate Aminotransferases/analysis
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Bilirubin/blood
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Chemical and Drug Induced Liver Injury/complications/*diagnosis/pathology
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Duodenal Ulcer/pathology
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Endoscopy, Digestive System
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Female
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Focal Nodular Hyperplasia/complications/*diagnosis/pathology
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Humans
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Liver/enzymology/pathology
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Magnetic Resonance Imaging
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Middle Aged
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Tomography, X-Ray Computed