1.Components and lipid-lowering effect of total saponins from underground part of Gynostemma pentaphyllum.
Fei TENG ; Xiang-Wei LI ; Min LI ; Dong-Dong FAN ; Jing-Jing ZHU ; Hui-Min GAO ; Zhi-Min WANG
China Journal of Chinese Materia Medica 2022;47(18):5022-5031
The saponins in different parts of Gynostemma pentaphyllum were analyzed via UPLC-Q-TOF-MS~E. A total of 46 saponins were identified, and the underground part had 26 saponins more than the aboveground part, most of which were trisaccharide saponins. The rat model of hyperlipidemia was established with high-fat diet. This study explored the lipid-lowering activity of total saponins in the underground part of G. pentaphyllum, so as to provide a theoretical basis for the comprehensive utilization of the underground part of G. pentaphyllum. A total of 99 healthy SD rats were randomly assigned into a blank group, a model group, a positive drug group, an aboveground total saponins group, and low-, medium-, and high-dose underground total saponins groups. Except the blank group, the other groups were fed with high-fat diet for 6 weeks. Then, the blood was collected from the orbital cavity to determine whether the modeling was successful according to the serum levels of total cholesterol(TC) and triglyceride(TG). After intragastric administration of the corresponding agents for 30 continuous days, the physical state of the rats were observed, and the body weight and liver specific gravity were measured. Furthermore, the levels of TC, TG, low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), alanine transaminase(ALT), aspartate transaminase(AST), bilirubin, and total bile acids in serum, as well as the levels of superoxide dismutase(SOD), malondialdehyde(MDA), peroxidase proliferator-activated receptor(PPAR-γ) in the liver tissue, were determined. The pathological changes of liver was observed via HE staining. The results showed that the aboveground total saponins and medium-and high-dose underground total saponins can treat hepatocyte steatosis, lower TC, TG, LDL-C, ALT, AST, total bilirubin, MDA, and PPAR-γ levels, and increase HDL-C and SOD levels in the model rats. The effect tended to be more obvious with the increase in dosage. Therefore, the total saponins in the underground part of G. pentaphyllum have good pharmacological effect of reducing blood lipid, which provides a theoretical basis for the comprehensive utilization of the underground part of G. pentaphyllum.
Alanine Transaminase/analysis*
;
Animals
;
Aspartate Aminotransferases/analysis*
;
Bile Acids and Salts/blood*
;
Bilirubin/blood*
;
Cholesterol, LDL/blood*
;
Diet, High-Fat/adverse effects*
;
Gynostemma/chemistry*
;
Hypolipidemic Agents/therapeutic use*
;
Lipoproteins, HDL/blood*
;
Liver/metabolism*
;
Malondialdehyde/analysis*
;
Peroxisome Proliferator-Activated Receptors/analysis*
;
Rats
;
Rats, Sprague-Dawley
;
Saponins/therapeutic use*
;
Superoxide Dismutase
;
Triglycerides/blood*
;
Trisaccharides/therapeutic use*
2.Cell metabolomics study of ginkgo flavone aglycone combined with doxorubicin against liver cancer in synergy.
Yuan LU ; Yan-Li WANG ; Zhong-Jun SONG ; Xiao-Qing ZHU ; Chun-Hua LIU ; Ji-Yu CHEN ; Yong-Jun LI ; Yan HE
China Journal of Chinese Materia Medica 2022;47(18):5040-5051
Ultra-high-performance liquid chromatography-Q exactive orbitrap tandem mass spectrometry(UHPLC-QEOrbitrap-MS/MS) was used to explore the inhibitory effect and mechanism of ginkgo flavone aglycone(GA) combined with doxorubicin(DOX) on H22 cells. The effects of different concentrations of GA and DOX on the viability of H22 cells were investigated, and combination index(CI) was used to evaluate the effects. In the experiments, control(CON) group, DOX group, GA group, and combined GA and DOX(GDOX) group were constructed. Then the metabolomics strategy was employed to explore the metabolic markers that were significantly changed after combination therapy on the basis of single medication treatment, and by analyzing their biological significance, the effect and mechanism of the anti-tumor effect of GA combined with DOX were explained. The results revealed that when 30 μg·mL~(-1) GA and 0.5 μmol·L~(-1) DOX was determined as the co-administration concentration, the CI value was 0.808, indicating that the combination of GA and DOX had a synergistic anti-tumor effect. Metabolomics analysis identified 23 metabolic markers, including L-arginine, L-tyrosine and L-valine, mostly amino acids. Compared with the CON group, 22 and 17 metabolic markers were significantly down-regulated after DOX treatment and GA treatment, respectively. Compared with the DOX and GA groups, the treatment of GA combined with DOX further down-regulated the levels of these metabolic markers in liver cancer, which might contribute to the synergistic effect of the two. Five key metabolic pathways were found in pathway enrichment analysis, including glutathione metabolism, phenylalanine metabolism, arginine and proline metabolism, β-alanine metabolism, and valine, leucine and isoleucine degradation. These findings demonstrated that the combination of GA and DOX remarkably inhibited the viability of H22 cells and exerted a synergistic anti-tumor effect. The mechanism might be related to the influence of the energy supply of tumor cells by interfering with the metabolism of various amino acids.
Arginine/therapeutic use*
;
Doxorubicin/therapeutic use*
;
Flavones/therapeutic use*
;
Ginkgo biloba/chemistry*
;
Glutathione
;
Humans
;
Isoleucine/therapeutic use*
;
Leucine/therapeutic use*
;
Liver Neoplasms/drug therapy*
;
Metabolomics/methods*
;
Phenylalanine/therapeutic use*
;
Proline
;
Tandem Mass Spectrometry/methods*
;
Tyrosine/therapeutic use*
;
Valine/therapeutic use*
;
beta-Alanine/therapeutic use*
3.Secondary metabolites of petri-dish cultured Antrodia camphorata and their hepatoprotective activities against alcohol-induced liver injury in mice.
Yu WU ; Wen-Jing TIAN ; Shuo GAO ; Zu-Jian LIAO ; Guang-Hui WANG ; Jir-Mehng LO ; Pei-Hsin LIN ; De-Quan ZENG ; Da-Ren QIU ; Xiang-Zhong LIU ; Mi ZHOU ; Ting LIN ; Hai-Feng CHEN
Chinese Journal of Natural Medicines (English Ed.) 2019;17(1):33-42
Antrodia camphorata, a well-known and highly valued edible medicinal mushroom with intriguing activities like liver protection, has been traditionally used for the treatment of alcoholic liver disease. A. camphorata shows highly medicinal and commercial values with the demand far exceeds the available supply. Thus, the petri-dish cultured A. camphorata (PDCA) is expected to develope as a substitute. In this paper, nineteen triterpenes were isolated from PDCA, and thirteen of them were the unique anthroic acids in A. camphorata, including the main content antcin K, which suggested that PDCA produced a large array of the same anthroic acids as the wild one. Furthermore, no obvious acute toxicity was found suggesting the edible safety of PDCA. In mice alcohol-induced liver injury model, triglyceride (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and malondialdehyde (MDA) had been reduced by the PDCA powder as well as the main content antcin K, which indicated that the PDCA could protect alcoholic liver injury in mice model and antcin K could be the effective component responsible for the hepatoprotective activities of PDCA against alcoholic liver diseases.
Alanine Transaminase
;
blood
;
Aldehyde Dehydrogenase
;
blood
;
Animals
;
Antrodia
;
chemistry
;
Aspartate Aminotransferases
;
blood
;
Biological Products
;
chemistry
;
pharmacology
;
therapeutic use
;
Chemical and Drug Induced Liver Injury
;
etiology
;
prevention & control
;
Cholestenes
;
chemistry
;
pharmacology
;
therapeutic use
;
Cholesterol, VLDL
;
blood
;
Disease Models, Animal
;
Ethanol
;
toxicity
;
Female
;
Fruiting Bodies, Fungal
;
chemistry
;
Liver
;
drug effects
;
metabolism
;
pathology
;
Liver Diseases, Alcoholic
;
prevention & control
;
Male
;
Malondialdehyde
;
blood
;
Mice
;
Molecular Structure
;
Triglycerides
;
blood
;
Triterpenes
;
chemistry
;
pharmacology
;
therapeutic use
4.Mechanism of Cinnamomi Ramulus improving rat model of intrahepatic cholestasis induced by ANIT by regulating FXR pathway.
Xin CAI ; Ren-Wu QIN ; Yu-Qing LIU ; Yao WANG ; Lei LUO ; Fan YANG
China Journal of Chinese Materia Medica 2019;44(12):2594-2599
To study the mechanism and action of Cinnamomi Ramulus in ameliorating intrahepatic cholestasis induced by α-isothiocyanate( ANIT) in rats by regulating FXR pathway. Forty SD rats were randomly divided into normal group,model group,positive control( ursodeoxycholic acid) group( 60 mg·kg~(-1)),Cinnamomi Ramulus treatment( 60 mg·kg~(-1)·d~(-1)) group,and Cinnamomi Ramulus treatment( 20 mg·kg~(-1)·d~(-1)) group,with 8 rats in each group. Except for the normal control group,the other groups were intragastrically administered with the corresponding concentrations of continuous aqueous solution( 0. 005 m L·g~(-1)),once a day,for 7 days.Except for the normal group,the other groups were treated with ANIT( 100 mg·kg~(-1)),once a day,for 3 days. Blood was taken from the abdominal aorta 24 hours after the last administration,and serum alanine aminotransferase( ALT),aspartate aminotransferase( AST),total bilirubin( TBi L),and total bile acid( TBA) were measured. 1. 5-2 cm of rat liver tissue was taken. After fixation with10% formaldehyde,paraffin-embedded sections were taken,HE staining was performed,and immunohistochemistry( IHC) was used to analyze the expression of FXR. RNA and protein were extracted from rat liver tissue to detect FXR mRNA expression,as well as bile acid synthesis and detoxification,transport related SHP,UGT2 B4,BSEP protein expressions at downstream of FXR. Compared with the normal group,serum ALT,AST,TBi L,and TBA levels were elevated in the model group( P<0. 01),liver damage was severe,FXR protein's optical density decreased,FXR mRNA expression decreased,and SHP,UGT2 B4,BSEP protein expressions were decreased( P<0. 05,P<0. 01). Compared with the model group,the drug group could reduce serum ALT,AST,TB,TBA levels to different degrees( P<0. 05,P<0. 01),alleviate liver tissue damage,increase the optical density of FXR protein,and promote the expressions of FXR mRNA and FXR,SHP,BSEP and UGT2 B4 proteins( P<0. 05,P<0. 01). Cinnamomi Ramulus can alleviate ANIT-induced intrahepatic cholestasis,and reduce hepatocyte injury and serum ALT,AST,TBi L and TBA levels. The mechanism may be through FXR-SHP,FXR-UGT2 B4,FXR-BSEP signaling pathways. Therefore,in the pathogenesis of intrahepatic cholestasis,we can try to further explore in alleviating intrahepatic cholestasis with Cinnamomi Ramulus,so as to provide effective drugs for clinical treatment of intrahepatic cholestasis.
Alanine Transaminase
;
blood
;
Animals
;
Aspartate Aminotransferases
;
blood
;
Bile Acids and Salts
;
blood
;
Bilirubin
;
blood
;
Cholestasis, Intrahepatic
;
chemically induced
;
drug therapy
;
Cinnamomum
;
chemistry
;
Isothiocyanates
;
Liver
;
Plant Extracts
;
pharmacology
;
RNA-Binding Proteins
;
metabolism
;
Random Allocation
;
Rats
;
Rats, Sprague-Dawley
5.Hot aqueous leaf extract of Lasianthera africana (Icacinaceae) attenuates rifampicin-isoniazid-induced hepatotoxicity.
Lucky Legbosi NWIDU ; Raphael Ellis TEME
Journal of Integrative Medicine 2018;16(4):263-272
OBJECTIVESThe aim of this study is to evaluate the hepatoprotective effect of Lasianthera africana (Icacinaceae) against isoniazid (INH) and rifampicin (RIF)-induced liver damage in rats.
METHODSThe hepatoprotective effects of hot aqueous L. africana (HALA) leaf extract (0.1-1 g/kg) and silymarin (50 mg/kg) were assessed in a model of oxidative liver damage induced by RIF and INH (100 mg/kg each) in Wistar rats for 28 days. Biochemical markers of hepatic damage such as alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were assessed. The antioxidant statuses of plasma glutathione peroxidase (GSPx), glutathione reductase (GSH), catalase (CAT) and superoxide dismutase (SOD) and lipid peroxidation were evaluated.
RESULTSThe pretreatment of INH and RIF decreased hematological indices and the antioxidant levels (P < 0.001) and increased the levels of liver marker enzymes (P < 0.001). However, pretreatment with HALA extract and silymarin provoked significant elevation of hematological indices. The levels of AST, ALT, and ALP were depressed (P < 0.001). Total triglycerides, total cholesterol, total bilirubin and low-density lipoprotein were decreased (P < 0.001). However, high-density lipoprotein, bicarbonate, and electrolytes like chloride and potassium were elevated (P < 0.001), but sodium was depressed (P < 0.05). Additionally, GSH, GSPx, SOD and CAT were elevated (P < 0.01) and malondialdehyde was depressed (P < 0.001) when compared to the RIF-INH-treated rats. Histopathological evaluations support hepatoprotective activity.
CONCLUSIONThis study demonstrated that HALA leaf extract attenuated RIF-INH-induced hepatotoxicity. L. africana could be exploited in management of RIF-INH-induced hepatitis.
Alanine Transaminase ; metabolism ; Animals ; Antibiotics, Antitubercular ; toxicity ; Aspartate Aminotransferases ; metabolism ; Chemical and Drug Induced Liver Injury ; drug therapy ; etiology ; metabolism ; Cholesterol ; metabolism ; Female ; Glutathione ; metabolism ; Humans ; Isoniazid ; toxicity ; Liver ; drug effects ; enzymology ; Magnoliopsida ; chemistry ; Male ; Malondialdehyde ; metabolism ; Plant Extracts ; administration & dosage ; Plant Leaves ; chemistry ; Rats, Wistar ; Rifampin ; toxicity ; Superoxide Dismutase ; metabolism
6.Protective effects of extracts of Schisandra chinensis stems against acetaminophen-induced hepatotoxicity via regulation of MAPK and caspase-3 signaling pathways.
Yan-Zi LI ; Zhi-Na MA ; Yin-Shi SUN ; Shen REN ; Shuang JIANG ; Wei-Zhe ZHANG ; Zi WANG ; Wei LI
Chinese Journal of Natural Medicines (English Ed.) 2018;16(9):700-713
The present study was designed to evaluate protective activity of an ethanol extract of the stems of Schisandra chinensis (SCE) and explore its possible molecular mechanisms on acetaminophen (APAP) induced hepatotoxicity in a mouse model. The results of HPLC analysis showed that the main components of SCE included schisandrol A, schisandrol B, deoxyschisandrin, schisandrin B, and schisandrin C and their contents were 5.83, 7.11, 2.13, 4.86, 0.42 mg·g, respectively. SCE extract was given for 7 consecutive days before a single hepatotoxic dose of APAP (250 mg·kg) was injected to mice. Our results showed that SCE pretreatment ameliorated liver dysfunction and oxidative stress, which was evidenced by significant decreases in aspartate transaminase (AST), alanine aminotransferase (ALT), malondialdehyde (MDA) contents and elevations in reduced glutathione (GSH) and superoxide dismutase (SOD) levels. These findings were associated with the result that the SCE pretreatment significantly decreased expression levels of 4-hydroxynonenal (4-HNE) and 3-nitrotyrosine (3-NT). SCE also significantly decreased the expression levels of Bax, mitogen- activated protein kinase (MAPK), and cleaved caspase-3 by APAP exposure. Furthermore, supplementation with SCE suppressed the expression levels of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2), suggesting alleviation of inflammatory response. In summary, these findings from the present study clearly demonstrated that SCE exerted significant alleviation in APAP-induced oxidative stress, inflammation and apoptosis mainly via regulating MAPK and caspase-3 signaling pathways.
Acetaminophen
;
adverse effects
;
Alanine Transaminase
;
metabolism
;
Animals
;
Apoptosis
;
drug effects
;
Aspartate Aminotransferases
;
metabolism
;
Caspase 3
;
genetics
;
metabolism
;
Chemical and Drug Induced Liver Injury
;
genetics
;
metabolism
;
physiopathology
;
prevention & control
;
Drugs, Chinese Herbal
;
administration & dosage
;
chemistry
;
Glutathione
;
metabolism
;
Humans
;
Liver
;
drug effects
;
metabolism
;
Male
;
Malondialdehyde
;
metabolism
;
Mice
;
Mice, Inbred ICR
;
Mitogen-Activated Protein Kinases
;
chemistry
;
genetics
;
metabolism
;
Oxidative Stress
;
drug effects
;
Schisandra
;
chemistry
;
Signal Transduction
;
drug effects
7.Ilexgenin A enhances the effects of simvastatin on non-alcoholic fatty liver disease without changes in simvastatin pharmacokinetics.
Ya-Wen LU ; Ying-Chao ZHU ; Li ZHANG ; Ping LI ; Jie YANG ; Xiao-Dong WEN
Chinese Journal of Natural Medicines (English Ed.) 2018;16(6):436-445
Cardiovascular disease (CVD) is the most common cause of death in patients with non-alcoholic fatty liver disease (NAFLD). New therapeutic strategies which have the potential for slowing down the evolution of NAFLD and reducing CVD-related mortality are urgently needed. Statins are well recognized in the treatment of dyslipidemia, but their use in the treatment of NAFLD is limited due to the safety concerns. Ilexgenin A (IA) is one of the main bioactive compounds in 'Shan-lv-cha', an herbal tea commonly used in China. In the present study, we investigated the possible synergistic therapeutic effects of IA and simvastatin (SV) on NAFLD. IA or SV showed beneficial effects on the rats with NAFLD by lowering the liver weight, liver index and plasma levels of alanine aminotransferase and aspartate aminotransferase, regulating abnormal metabolism of lipids and ameliorating steatosis in liver. IA significantly enhanced the hypolipidemic and anti-inflammation effects of SV. Furthermore, a sensitive, accurate, convenient and reproducible LC-MS method was developed to investigate the effects of IA on the pharmacokinetics of SV. No significant changes were observed in pharmacokinetic parameters of SV and simvastatin hydroxy acid in the IA plus SV co-treated group in comparison with those in the group treated with SV alone. The mRNA levels and activity of CYP3A1 were not altered by IA. In conclusion, the results obtained from the present study should be helpful for further clinical application of SV and IA alone or in combination.
Alanine Transaminase
;
metabolism
;
Animals
;
Aspartate Aminotransferases
;
metabolism
;
Cytochrome P-450 CYP3A
;
genetics
;
metabolism
;
Diet, High-Fat
;
Disease Models, Animal
;
Drug Synergism
;
Drug Therapy, Combination
;
Lipids
;
blood
;
Liver
;
metabolism
;
pathology
;
physiopathology
;
Male
;
Molecular Structure
;
Non-alcoholic Fatty Liver Disease
;
blood
;
drug therapy
;
Rats
;
Rats, Sprague-Dawley
;
Simvastatin
;
analogs & derivatives
;
pharmacokinetics
;
therapeutic use
;
Transcription, Genetic
;
Triterpenes
;
chemistry
;
therapeutic use
8.Metabolic profiling of endogenous bile acids: a novel method to assess hepatoprotective effect of Tanreqing capsule on carbon-tetrachloride-induced liver injury in rats.
Ying XU ; Ping-Ping ZHONG ; Yan-Yan TAO
Chinese Journal of Natural Medicines (English Ed.) 2018;16(4):271-283
Tanreqing (TRQ), a traditional Chinese medicine (TCM) formula, can alleviate liver injury and improve liver function. Its pharmacological mechanisms of actions are still unclear due to its complex components and multi-target natures. Metabolomic study is an effective approach to investigating drug pharmacological actions, new diagnostic markers, and potential mechanisms of actions. In the present study, a new strategy was used to evaluate the protective effect of TRQ capsule against carbon tetrachloride (CCl)-induced hepatotoxicity in rats, by analyzing metabolic profiling of endogenous bile acids (BAs) along with biochemical and histological analyses. BAs concentrations were determined by ultra-performance liquid chromatography coupled with quadrupole mass spectrometry (UPLC-MS). Principal component analysis and partial least squares discriminant analysis were then employed to analyze the UPLC-MS results and compare the hepatoprotective effect of TRQ capsule in different groups at the doses of 0.36, 1.44, and 2.88 g·kg body weight, respectively. Moreover, our results suggested that taurocholic acid (TCA) and taurohyodesoxycholic acid (THDCA) were the most important biochemical markers, which were indicative of CCl-induced acute hepatic damage and hepatoprotective effect of TRQ capsule. Therefore, this new strategy would be an excellent alternative method for evaluating hepatoprotective effect and proposing potential mechanisms of action for other drugs as well.
Alanine Transaminase
;
blood
;
Animals
;
Aspartate Aminotransferases
;
blood
;
Bile Acids and Salts
;
blood
;
metabolism
;
Biomarkers
;
blood
;
Carbon Tetrachloride
;
pharmacology
;
Chemical and Drug Induced Liver Injury
;
drug therapy
;
metabolism
;
pathology
;
Chromatography, Liquid
;
Drugs, Chinese Herbal
;
chemistry
;
pharmacology
;
therapeutic use
;
Female
;
Liver
;
drug effects
;
pathology
;
Male
;
Mass Spectrometry
;
Metabolome
;
drug effects
;
Metabolomics
;
Rats
;
Rats, Wistar
;
Taurocholic Acid
;
blood
;
Taurodeoxycholic Acid
;
analogs & derivatives
;
blood
9.Annual Report on the External Quality Assessment Scheme for Clinical Chemistry in Korea (2015).
Sun Hee JUN ; Junghan SONG ; Woon Heung SONG
Journal of Laboratory Medicine and Quality Assurance 2016;38(3):111-119
The Clinical Chemistry Subcommittee of the Korean Association for External Quality Assessment Service conducted external quality assessments in 2015. This included general chemistry and blood gas measurements as part of a scheme of six trials, comprising three samples each. All control materials were included at the same time. The overall response rates were 94.4% for general chemistry and 92.2% for blood gas. The parameters tested included sodium, potassium, chloride, blood urea nitrogen, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, aspartate aminotransferase (AST), alanine transaminase (ALT), alkaline phosphatase, lactate dehydrogenase, gamma glutamyl transferase, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol for general chemistry, and pH, partial pressure of carbon dioxide (pCO₂), and partial pressure of oxygen (pO₂) for blood gas assessments. Two types of reports were generated: a method summary, including mean, standard deviation, and coefficient of variation for each test method; and a result summary of each participating laboratory, including mean, standard deviation, number of peer groups, and standard deviation index and variance index scores of each laboratory. The overall quality performance in 2015 was similar to that of previous years, and showed lower interlaboratory variation than that in 2014. The requisite continual improvement in clinical chemistry testing quality can be achieved through participation in similar proficiency testing programs.
Alanine Transaminase
;
Alkaline Phosphatase
;
Aspartate Aminotransferases
;
Bilirubin
;
Blood Urea Nitrogen
;
Calcium
;
Carbon Dioxide
;
Chemistry
;
Chemistry, Clinical*
;
Cholesterol
;
Clinical Chemistry Tests
;
Creatinine
;
Glucose
;
Hydrogen-Ion Concentration
;
Korea*
;
L-Lactate Dehydrogenase
;
Lipoproteins
;
Methods
;
Oxygen
;
Partial Pressure
;
Peer Group
;
Phosphorus
;
Potassium
;
Sodium
;
Transferases
;
Triglycerides
;
Uric Acid
10.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
;
Alanine Transaminase/analysis
;
Aspartate Aminotransferases/analysis
;
Chemical and Drug Induced Liver Injury/*diagnosis
;
Hemoglobins/analysis
;
Humans
;
Lead/analysis
;
*Lead Poisoning
;
Liver/enzymology/metabolism
;
Liver Function Tests
;
Male
;
Middle Aged
;
Plants, Medicinal/chemistry

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