Liver injury induced by Jingangteng capsules (金刚藤胶囊) combined with Kangfuyan capsules (康妇炎胶囊)
10.3760/cma.j.cn114015-20201119-01158
- VernacularTitle:金刚藤胶囊联合康妇炎胶囊致肝损伤
- Author:
Xiaojuan LI
1
;
Aiwu ZHANG
1
Author Information
1. 内蒙古医科大学附属医院药剂部，呼和浩特 010050
- Publication Type:Journal Article
- Keywords:
Chemical and drug induced liver injury;
Drugs, Chinese herbal;
Smilax
- From:
Adverse Drug Reactions Journal
2021;23(5):273-274
- CountryChina
- Language:Chinese
-
Abstract:
A 46-year-old female patient was treated with Jingangteng capsules 2 g (4 capsules) thrice daily and Kangfuyan capsules 1.2 g (3 capsules) twice daily after hysterectomy. After 23 days of treatments, the patient developed gastrointestinal discomfort, and Jingangteng capsules and Kangfuyan capsules were stopped 2 days later. However, gastrointestinal discomfort gradually worsened and symptoms such as nausea, dark urine, and yellow staining of the skin and sclera appeared. After discontinuing the drug for 10 days, laboratory tests showed alanine aminotransferase (ALT) 366 U/L, aspartate aminotransferase (AST) 485 U/L, alkaline phosphatase (ALP) 145 U/L, gamma glutamyltransferase (γ-GT) 67 U/L, total bilirubin (TBil) 67.1 μmol/L, and direct bilirubin (DBil) 59.5 μmol/L. Viral hepatitis and biliary obstruction were excluded by laboratory tests and imaging examination, and drug-induced liver injury was diagnosed. Oral liver-protective drugs and IV infusions of compound glycyrrhizin injection and polyene phosphatidylcholine injection were given successively, but jaundice continued to deepen with the peak TBil and DBil values of 189.7 μ mol/L and 159.4 μ mol/L, respectively. An IV infusion of ademetionine 1,4-butanedisulfonate for injection 1 g dissolved in 5% glucose injection 250 ml was given once daily. Three days later, the patient′s symptoms were improved and the jaundice subsided obviously; 9 days later, the liver function was improved obviously and laboratory tests showed ALT 29 U/L, AST 50 U/L, γ-GT 36 U/L, TBil 66.5 μmol/L, and DBil 53.2 μmol/L; 1 month later, her liver function returned to normal.
