A 25-year-old female patient took Congrong Tongbian oral liquid 20 ml once daily by herself for constipation. After 3 months of intermittent medication, the patient gradually developed dark urine and yellowish skin and sclera, accompanied by nausea, vomiting, and decreased appetite; 4 months later, laboratory tests showed alanine aminotransferase (ALT) 1 359 U/L, aspartate aminotransferase (AST) 859 U/L, alkaline phosphatase (ALP) 160 U/L, total bilirubin (TBil) 131.5 μmol/L, and direct bilirubin (DBil) 99.3 μmol/L. Liver injury caused by Congrong Tongbian oral liquid was considered, then the drug was discontinued, and IV infusions of magnesium isoglycyrrhizinate injection 200 mg dissolved in 5% glucose injection 250 ml once daily and polyene phosphatidylcholine injection 20 ml dissolved in 5% glucose injection 250 ml once daily were given. After the above treatments, the patient′s symptoms were gradually improved. Two weeks later, the patient′s urine color was basically normal, gastrointestinal symptoms disappeared, and liver function showed ALT 137 U/L, AST 87 U/L, ALP 126 U/L, and TBil 34.9 μmol/L. At a 2-month follow-up, the patient′s liver function returned to normal. The patient′s liver injury was most likely related to the Polygonum multiflorum in Congrong Tongbian oral liquid.

A 25-year-old female patient took Congrong Tongbian oral liquid 20 ml once daily by herself for constipation. After 3 months of intermittent medication, the patient gradually developed dark urine and yellowish skin and sclera, accompanied by nausea, vomiting, and decreased appetite; 4 months later, laboratory tests showed alanine aminotransferase (ALT) 1 359 U/L, aspartate aminotransferase (AST) 859 U/L, alkaline phosphatase (ALP) 160 U/L, total bilirubin (TBil) 131.5 μmol/L, and direct bilirubin (DBil) 99.3 μmol/L. Liver injury caused by Congrong Tongbian oral liquid was considered, then the drug was discontinued, and IV infusions of magnesium isoglycyrrhizinate injection 200 mg dissolved in 5% glucose injection 250 ml once daily and polyene phosphatidylcholine injection 20 ml dissolved in 5% glucose injection 250 ml once daily were given. After the above treatments, the patient′s symptoms were gradually improved. Two weeks later, the patient′s urine color was basically normal, gastrointestinal symptoms disappeared, and liver function showed ALT 137 U/L, AST 87 U/L, ALP 126 U/L, and TBil 34.9 μmol/L. At a 2-month follow-up, the patient′s liver function returned to normal. The patient′s liver injury was most likely related to the Polygonum multiflorum in Congrong Tongbian oral liquid.