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*
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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.Study on protective effect of water extract from Sabia parviflora on liver injury in mice induced by acetaminophen.
Jian-Qiao LI ; Wen-Feng HUANG ; Hai-Bo HE ; Dong-Xiao ZHAO ; Jian-Zhong HU ; Shun-Guang LU ; Jia-Xin YE ; Kun ZOU
China Journal of Chinese Materia Medica 2020;45(6):1433-1439
The aim of this study was to observe the protective effect of water extract from Sabia parviflora on mice with acute liver injury induced by acetaminophen, and investigate its possible mechanism. Fifty-eight Kunming mice were divided into 6 groups, 8 in the normal group, 10 in the model group, 10 in the biphenyl diester group, and 10 each in the low, medium and high dose groups. After adaptive feeding for one week, the mice in normal group were intragastrically administered with an equal volume of 0.5% sodium carboxymethylcellulose sodium(CMC-Na), and the mice in other groups were intragastrically administered with corresponding drugs at 20 mL·kg~(-1) once a day. Then acetaminophen(200 mg·kg~(-1)) was administered after the above drug administration except the normal group. The behavior and signs of the experimental animals were observed every day and the samples were taken for experiments on the next day of the final administration. The liver mass and mass index were calculated. The blood was collected from the abdominal aorta and centrifuged to obtain the serum for detecting aspartate aminotransferase(AST) activity and alanine aminotransferase(ALT) activity. The liver tissue homogenate was used to detect superoxide dismutase(SOD) activity, glutathione(glutathione, r-glutamyl cysteingl+glycine, GSH) activity and malondialdehyde(MDA) content. Liver tissue was analyzed for histological analysis. The results showed that S. parviflora could alleviate the lipid peroxidation damage in the liver caused by acetaminophen, reduce the ALT and AST activities in serum, increase the levels of SOD and GSH in liver tissue, decrease the content of MDA in liver tissue, and inhibit the apoptosis. S. parviflora could also improve the live histopathological profile, protect liver cells and restore liver function. Among them, the high dose had the most significant effect and showed dose-effect relationship. This study indicated that S. parviflora had a significant protective effect on acetaminophen-induced liver injury in mice, and its mechanism may be related to its anti-oxidation effect and inhi-bitory effect on apoptosis.
Acetaminophen/toxicity*
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Alanine Transaminase/metabolism*
;
Animals
;
Aspartate Aminotransferases/metabolism*
;
Chemical and Drug Induced Liver Injury/drug therapy*
;
Liver/enzymology*
;
Malondialdehyde/analysis*
;
Mice
;
Oxidative Stress
;
Plant Extracts/pharmacology*
;
Superoxide Dismutase/metabolism*
3.Effect of autophagy inhibitor chloroquine on acute alcoholinduced liver disease.
Wen-Hua SANG ; Mei-Chun ZENG ; Sha CHEN ; Ran CHEN ; Xiao-Fang FAN ; Yong-Sheng GONG ; Hai-Lin ZHANG ; Hong-Yu ZHANG ; Xiao-Xia KONG
Chinese Journal of Applied Physiology 2018;34(2):102-105
OBJECTIVES:
To investigate the role of autophagy inhibitor chloroquine (CQ) in acute ethanol-induced liver injury and its mechenism.
METHODS:
Twenty-one C57BL/6 male mice were randomly divided into three groups:control group, ethanol group, CQ + ethanol group (=7). Mice in ethanol group were administered 33% (v/v) ethanol at a dose of 4.5 g/kg body weight. Ethanol-induced liver steatosis in each group was detected by hematoxylin and eosin staining. Hepatic lipid accumulation was detected by staining with Oil red O. Hepatic tissue triglyceride (TG) levels, serum aspartate aminotransferase(AST) and alanine aminotransferase(ALT) were determined by biochemical assays. Protein expression of microtubule-associated protein 1 light chain 3(LC3) and nuclear factorκB p65(NF-κB p65) were measured by Western blot and immunofluorescence. Pro-inflammatory factors tumor necrosis factor-α(TNF-α)、interleukin 6(IL-6) were detected by ELISA.
RESULTS:
Compared with control group, ethanol induced liver injury proved by accumulation of hepatic lipids, TG levels, AST and ALT activities were significantly increased by ethanol, protein expression of LC3-Ⅱ was also markedly increased by ethanol. Compared with ethanol group, addition of CQ increased furtherthe level of LC3-Ⅱexpression, and TG amount, serum AST and ALT activities, and the expression of NF-κB p65, TNF-αand IL-6.
CONCLUSIONS
Acute ethanol-intake could induce liver steatosis and inflammation, and autophagy inhibitor CQ exacerbatedethanol-induced liver injury, suggested that autophagy might be protective effect in acute ethanol-induced liver disease.
Alanine Transaminase
;
blood
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Animals
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Aspartate Aminotransferases
;
blood
;
Autophagy
;
drug effects
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Chloroquine
;
pharmacology
;
Interleukin-6
;
analysis
;
Liver
;
drug effects
;
Liver Diseases, Alcoholic
;
drug therapy
;
Male
;
Mice
;
Mice, Inbred C57BL
;
Microtubule-Associated Proteins
;
metabolism
;
Random Allocation
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Transcription Factor RelA
;
metabolism
;
Triglycerides
;
analysis
;
Tumor Necrosis Factor-alpha
;
analysis
4.Association between protective effect of Liuwei Wuling tablets against acute liver injury and its inhibitory effect on cytoplasmic translocation of high-mobility group box-1 in hepatocytes in mice.
Yangchang LEI ; Wen LI ; Pan LUO
Chinese Journal of Hepatology 2016;24(2):114-118
OBJECTIVETo investigate the effect of Liuwei Wuling tablets on the cytoplasmic translocation and release of high-mobility group box-1 (HMGB1) in hepatocytes in mice with acute live injury induced by D-galactosamine (D-GalN) and lipopolysaccharide (LPS).
METHODSA Balb/c mouse model of acute liver injury was established by intraperitoneal injection of D-GalN (400 mg/kg) and LPS (5 ug/kg). A total of 24 healthy mice were randomly and equally divided into acute liver injury control group and Liuwei Wuling tablet treatment group. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured in both groups at each time point within one week. Liver tissues were collected at 36 hours to perform pathological examination. The serum levels of HMGB1, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), complement 3a (C3a), and complement 5a (C5a) were measured. Immunohistochemistry was used to determine the expression and cytoplasmic translocation of HMGB1 in hepatocytes.
RESULTSAt 6, 12, and 24 hours, the Liuwei Wuling tablet treatment group had significantly lower serum levels of ALT than the control group (225.33±181.64 U/L vs 471.17±174.72 U/L, t = 3.38, P < 0.01; 1509.53±182.51 U/L vs 7149.52±734.25 U/L, t = 25.82, P < 0.01; 162.89±86.51 U/L vs 1318.16±557.71 U/L, t = 7.09, P < 0.01), as well as significantly lower serum levels of AST than the control group (179.22±94.57 U/L vs 561.91±209.6 U/L, t = 5.76, P < 0.01; 590.92±190.92 U/L vs 2266.48±705.64 U/L, t = 7.94, P < 0.01; 231.24±87.7 U/L vs 444.32±117.01 U/L, t = 5.05, P < 0.01). The treatment group had significantly lower levels of HMGB1 than the control group at 6 and 12 hours (54.21±11.89 ng/ml vs 72.07±13.65 ng/ml, t = 3.41, P < 0.01; 49.23±5.97 ng/ml vs 68.71±13.07 ng/ml, t = 4.70, P < 0.01). The treatment group had significantly lower levels of TNF-α, IL-1β, and IL-6 than the control group at 12 hours (163.62±9.12 pg/ml vs 237.09±51.47 pg/ml, t = 4.86, P < 0.01; 15.66±13.13 pg/ml vs 37.43±18.68 pg/ml, t = 3.30, P < 0.01; 7.10±3.06 pg/ml vs 21.42±8.23 pg/ml, t = 5.65, P < 0.01). The treatment group had significantly lower levels of C3a and C5a than the control group at 12 hours (2.52±1.27 pg/ml vs 9.83±2.96 ng/ml, t = 7.86, P < 0.01; 2.16±1.03 ng/ml vs 7.23±1.55 ng/ml, t = 9.67, P < 0.01). Compared with the control group, the treatment group had significantly reduced liver inflammation and necrosis, and a significantly lower cytoplasmic translocation rate of HMGB1 in hepatocytes (38.76%±7.37% vs 8.15%±2.11%, P < 0.01).
CONCLUSIONLiuwei Wuling tablets can reduce the cytoplasmic translocation of HMGB1 in hepatocytes and relieve liver inflammation in mice with acute liver injury.
Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Complement C3a ; analysis ; Complement C5a ; analysis ; Cytoplasm ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Galactosamine ; HMGB1 Protein ; metabolism ; Hepatocytes ; drug effects ; Interleukin-1beta ; blood ; Interleukin-6 ; blood ; Lipopolysaccharides ; Liver Failure, Acute ; drug therapy ; Mice ; Mice, Inbred BALB C ; Protein Transport ; Tablets ; Tumor Necrosis Factor-alpha ; blood
5.Magnetization-tagged MRI is a simple method for predicting liver fibrosis.
Kyung Eun KIM ; Mi Suk PARK ; Sohae CHUNG ; Chansik AN ; Leon AXEL ; Rakhmonova Gulbahor ERGASHOVNA
Clinical and Molecular Hepatology 2016;22(1):140-145
BACKGROUND/AIMS: To assess the usefulness of magnetization-tagged magnetic resonance imaging (MRI) in quantifying cardiac-induced liver motion and deformation in order to predict liver fibrosis. METHODS: This retrospective study included 85 patients who underwent liver MRI including magnetization-tagged sequences from April 2010 to August 2010. Tagged images were acquired in three coronal and three sagittal planes encompassing both the liver and heart. A Gabor filter bank was used to measure the maximum value of displacement (MaxDisp) and the maximum and minimum values of principal strains (MaxP1 and MinP2, respectively). Patients were divided into three groups (no fibrosis, mild-to-moderate fibrosis, and significant fibrosis) based on their aspartate-aminotransferase-to-platelet ratio index (APRI) score. Group comparisons were made using ANOVA tests. RESULTS: The patients were divided into three groups according to APRI scores: no fibrosis (≤0.5; n=41), moderate fibrosis (0.5-1.5; n=23), and significant fibrosis (>1.5; n=21). The values of MaxDisp were 2.9±0.9 (mean±SD), 2.3±0.7, and 2.1±0.6 in the no fibrosis, moderate fibrosis, and significant fibrosis groups, respectively (P<0.001); the corresponding values of MaxP1 were 0.05±0.2, 0.04±0.02, and 0.03±0.01, respectively (P=0.002), while those of MinP2 were -0.07±0.02, -0.05±0.02, and -0.04±0.01, respectively (P<0.001). CONCLUSIONS: Tagged MRI to quantify cardiac-induced liver motion can be easily incorporated in routine liver MRI and may represent a helpful complementary tool in the diagnosis of early liver fibrosis.
Aged
;
Aspartate Aminotransferases/analysis
;
Blood Platelets/cytology
;
Humans
;
Liver Cirrhosis/*diagnostic imaging/metabolism/pathology
;
*Magnetic Resonance Imaging
;
Male
;
Middle Aged
;
Retrospective Studies
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Severity of Illness Index
6.Doxazosin Treatment Attenuates Carbon Tetrachloride-Induced Liver Fibrosis in Hamsters through a Decrease in Transforming Growth Factor beta Secretion.
Martin Humberto MUNOZ-ORTEGA ; Raul Wiliberto LLAMAS-RAMIREZ ; Norma Isabel ROMERO-DELGADILLO ; Tania Guadalupe ELIAS-FLORES ; Edgar DE JESUS TAVARES-RODRIGUEZ ; Maria DEL ROSARIO CAMPOS-ESPARZA ; Daniel CERVANTES-GARCIA ; Luis MUNOZ-FERNANDEZ ; Martin GERARDO-RODRIGUEZ ; Javier VENTURA-JUAREZ
Gut and Liver 2016;10(1):101-108
BACKGROUND/AIMS: The development of therapeutic strategies for the treatment of cirrhosis has become an important focus for basic and clinical researchers. Adrenergic receptor antagonists have been evaluated as antifibrotic drugs in rodent models of carbon tetrachloride (CCl4)-induced cirrhosis. The aim of the present study was to evaluate the effects of carvedilol and doxazosin on fibrosis/cirrhosis in a hamster animal model. METHODS: Cirrhotic-induced hamsters were treated by daily administration of carvedilol and doxazosin for 6 weeks. Hepatic function and histological evaluation were conducted by measuring biochemical markers, including total bilirubin, aspartate aminotransferase, alanine aminotransferase and albumin, and liver tissue slices. Additionally, transforming growth factor beta (TGF-beta) immunohistochemistry was analyzed. RESULTS: Biochemical markers revealed that hepatic function was restored after treatment with doxazosin and carvedilol. Histological evaluation showed a decrease in collagen type I deposits and TGF-beta-secreting cells. CONCLUSIONS: Taken together, these results suggest that the decrease in collagen type I following treatment with doxazosin or carvedilol is achieved by decreasing the profibrotic activities of TGF-beta via the blockage of alpha1- and beta-adrenergic receptor. Consequently, a diminution of fibrotic tissue in the CCl4-induced model of cirrhosis is achieved.
Adrenergic alpha-1 Receptor Antagonists/*pharmacology
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Alanine Transaminase/blood
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Animals
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Aspartate Aminotransferases/blood
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Bilirubin/blood
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Carbazoles/*pharmacology
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Carbon Tetrachloride
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Collagen Type I/drug effects/metabolism
;
Cricetinae
;
Doxazosin/*pharmacology
;
Liver/metabolism/pathology
;
Liver Cirrhosis/blood/chemically induced/*drug therapy
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Liver Function Tests
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Propanolamines/*pharmacology
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Serum Albumin/analysis
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Transforming Growth Factor beta/blood/*drug effects
7.Irritable Bowel Syndrome May Be Associated with Elevated Alanine Aminotransferase and Metabolic Syndrome.
Seung Hwa LEE ; Kyu Nam KIM ; Kwang Min KIM ; Nam Seok JOO
Yonsei Medical Journal 2016;57(1):146-152
PURPOSE: Recent studies have revealed close relationships between hepatic injury, metabolic pathways, and gut microbiota. The microorganisms in the intestine also cause irritable bowel syndrome (IBS). The aim of this study was to examine whether IBS was associated with elevated hepatic enzyme [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)], gamma-glutamyl transferase (gamma-GT) levels, and metabolic syndrome (MS). MATERIALS AND METHODS: This was a retrospective, cross-sectional, case-control study. The case and control groups comprised subjects who visited our health promotion center for general check-ups from June 2010 to December 2010. Of the 1127 initially screened subjects, 83 had IBS according to the Rome III criteria. The control group consisted of 260 age- and sex-matched subjects without IBS who visited our health promotion center during the same period. RESULTS: Compared to control subjects, patients with IBS showed significantly higher values of anthropometric parameters (body mass index, waist circumference), liver enzymes, gamma-GT, and lipid levels. The prevalences of elevated ALT (16.9% vs. 7.7%; p=0.015) and gamma-GT (24.1% vs. 11.5%; p=0.037) levels were significantly higher in patients with IBS than in control subjects. A statistically significant difference was observed in the prevalence of MS between controls and IBS patients (12.7% vs. 32.5%; p<0.001). The relationships between elevated ALT levels, MS, and IBS remained statistically significant after controlling for potential confounding factors. CONCLUSION: On the basis of our study results, IBS may be an important condition in certain patients with elevated ALT levels and MS.
Adult
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Alanine Transaminase/analysis/*metabolism
;
Aspartate Aminotransferases/analysis/*metabolism
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Body Mass Index
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Case-Control Studies
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Cross-Sectional Studies
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Female
;
Humans
;
Irritable Bowel Syndrome/diagnosis/*enzymology/epidemiology
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Liver/metabolism
;
Male
;
Metabolic Syndrome X/complications/diagnosis/*enzymology/epidemiology
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Middle Aged
;
Obesity/epidemiology
;
Prevalence
;
Retrospective Studies
;
Waist Circumference
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gamma-Glutamyltransferase/analysis/*metabolism
8.Analysis of risk factors of Budd-Chiari syndrome complicated with hepatocellular carcinoma.
Xiaowei DANG ; Email: DANGXW1001@163.COM. ; Luhao LI ; Suxin LI ; Yafei WANG ; Hai LI ; Shaokai XU ; Kunkun FU ; Peiqin XU
Chinese Journal of Surgery 2015;53(7):492-495
OBJECTIVETo investigate the risk factors of Budd-Chiari syndrome (B-CS) complicated with hepatocellular carcinoma (HCC).
METHODSThe clinical data of 30 patients with B-CS complicated with HCC treated in the First Affiliated Hospital of Zhengzhou University from December 2012 to November 2014 were analyzed retrospectively, 106 another patients were selected randomly as control group in the same term. Gender, age, medical history, type of B-CS, hemoglobin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, Child-Pugh classification, portal vein diameter, HBV infection and drinking history were recorded and analyzed between the two groups. Univariate analysis and unconditional Logistic regression model were performed to screen corresponding risk factors. Area under curve (AUC) was calculated according to receiver operator characteristic (ROC) curve to evaluate the diagnostic value of each indicator.
RESULTSUnivariate analysis showed that there were no statistical differences in gender (χ² =0.001), age (t=0.317), medical history (t=-0.906), type of B-CS (χ² =2.894), ALT (t=-1.581), Child-Pugh classification (Z=-0.777), HBV infection (χ² =0.016) and drinking history (χ² =0.285) between the two groups (all P > 0.05), but the hemoglobin (t=3.370) and albumin (t=2.152) in HCC group were lower and AST (t=-2.425) and portal vein diameter (t=-2.554) were higher than that in the other group, and the differences were statistically significant (all P <0.05). The results of unconditional Logistic regression model analysis indicated that hemoglobin, AST and portal vein diameter were independent risk factors of B-CS complicated with HCC (OR=0.972, 1.015, 1.206; P=0.004, 0.022, 0.012). ROC curve analysis indicated that the AUC of AST, hemoglobin and portal vein diameter was 0.704, 0.324 and 0.624, the predicate value was, in order, AST, portal vein diameter, hemoglobin.
CONCLUSIONHemoglobin, AST and portal vein diameter are independent risk factors of B-CS complicated with HCC.
Area Under Curve ; Aspartate Aminotransferases ; metabolism ; Budd-Chiari Syndrome ; complications ; Carcinoma, Hepatocellular ; complications ; Case-Control Studies ; Child ; Hemoglobins ; analysis ; Humans ; Liver Neoplasms ; complications ; Logistic Models ; Portal Vein ; pathology ; ROC Curve ; Retrospective Studies ; Risk Factors
9.A Case of Autoimmune Hepatitis Combined with Graves' Disease.
Jong Hyun JHEE ; Hyun Ju KIM ; Wonseok KANG ; Sewha KIM ; Do Young KIM
The Korean Journal of Gastroenterology 2015;65(1):48-51
A 25-year-old woman presented with jaundice, palpitation, and weight loss of 5 kg during a period of 2 weeks. Laboratory tests showed elevated levels of liver enzymes (AST 1,282 IU/L, ALT 1,119 IU/L) and total bilirubin (6.4 mg/dL); negative for hepatitis virus infection; elevated serum levels of triiodothyronine (T3, 3.60 ng/dL), free thyroxine (fT4, 3.82 ng/dL), and lowered serum level of thyroid stimulating hormone (TSH, <0.025 microIU/mL); and positive for thyroid stimulating antibody and anti-mitochondrial antibody (AMA). The liver biopsy findings were consistent with autoimmune hepatitis (AIH). Accordingly, oral steroid therapy was started with 60 mg of prednisolone under the impression of AIH associated with Graves' disease. After a week of steroid therapy, the clinical manifestation showed significant improvement, with normalization of both liver and thyroid functions. Diagnosis of the liver condition of patients who present with hyperthyroidism and liver dysfunction is important, so that appropriate therapy can be promptly initiated.
Adult
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Alanine Transaminase/analysis
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Antibodies, Antinuclear/blood
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Aspartate Aminotransferases/analysis
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Bilirubin/blood
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Female
;
Graves Disease/complications/*diagnosis/drug therapy
;
Hepatitis, Autoimmune/complications/*diagnosis/drug therapy
;
Humans
;
Immunoglobulins, Thyroid-Stimulating/blood
;
Liver/enzymology/metabolism/pathology
;
Prednisolone/therapeutic use
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Steroids/therapeutic use
;
Thyrotropin/blood
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
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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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