Severe liver injury caused by compound Zaoren capsules (复方枣仁胶囊)
10.3760/cma.j.cn114015-20220823-00772
- VernacularTitle:复方枣仁胶囊致重度肝损伤
- Author:
Xin ZHANG
1
;
Qingdong TONG
1
;
Jiamin SUN
1
Author Information
1. 龙岩市第二医院感染科，龙岩 364000
- Publication Type:Journal Article
- Keywords:
Drug-induced liver injury;
Tetrahydropalmatine;
Compound Zaoren capsules;
Traditional Chinese and western medicine compound preparation
- From:
Adverse Drug Reactions Journal
2023;25(10):638-640
- CountryChina
- Language:Chinese
-
Abstract:
A 20-year-old female patient took compound Zaoren capsules (containing processed ziziphi Spinosae Semen and L-tatrahydropal matine, 1 capsule at bedtime, 12 capsules in total) by herself intermittently due to insomnia. Fifteen days later, she developed fatigue and dark yellow urine. Laboratory tests showed total bilirubin (TBil) 62 μmol/L, direct bilirubin (DBil) 49 μmol/L, alanine aminotransferase (ALT) 1 658 U/L, aspartate aminotransferase (AST) 1 525 U/L, γ-glutamic trans-ferase (GGT) 160 U/L, alkaline phosphatase (ALP) 149 U/L, and total bile acid (TBA) 90.2 μmol/L. She received liver-protective treatments. After 30 days, the symptoms of fatigue and dark yellow urine were relieved, and laboratory tests showed TBil 24 μmol/L, DBil 13 μmol/L, ALT 54 U/L, AST 68 U/L, GGT 170 U/L, and ALP 90 U/L. Nine months later, the patient took compound Zaoren capsules (1 capsule/4 d, 3 capsules in total) again due to insomnia. Fourteen days later, the patient developed yellow sclera and dark yellow urine, and laboratory tests showed TBil 44 μmol/L, DBil 29 μmol/L, ALT 2 041 U/L, AST 1 152 U/L, GGT 110 U/L, ALP 155 U/L, and TBA 28.0 μmol/L. The liver-protective treatments were given again, and the symptoms of yellow sclera and urine were relieved 18 days later. Laboratory tests showed ALT 199 U/L, AST 78 U/L, and GGT 55 U/L. The liver injury is considered to be caused by tetrahydropalmatine in compound Zaoren capsules.
