医学
中止
青蒿素
自身免疫性肝炎
肝损伤
肝炎
内科学
重症监护医学
免疫学
疟疾
恶性疟原虫
作者
Akash Mathavan,Akshay Mathavan,Urszula Krekora,Karen Daily
出处
期刊:Case Reports
[BMJ]
日期:2023-05-01
卷期号:16 (5): e251852-e251852
被引量:2
标识
DOI:10.1136/bcr-2022-251852
摘要
Immune-mediated herb-induced liver injury (HILI) is an acute or chronic inflammatory liver disease precipitated by a hepatotoxic agent with a presentation similar to acute autoimmune hepatitis. It is distinguished in clinical course from true autoimmune hepatitis by remission on drug discontinuation and immunosuppressive treatment. We report a potential case of immune-mediated HILI associated with artemisinin use, an herb underlying first-line malarial treatments, in a woman undergoing radiotherapy for right-sided pelvic sarcoma. A probable association in this case is supported by causality assessment using the updated Roussel Uclaf Causality Assessment Method (score of 6). She achieved clinical improvement with a course of oral corticosteroids and remained stable without relapse following discontinuation. Increased awareness of this complication is imperative, as literature to date only documents direct hepatocellular and cholestatic liver injury from artemisinin use, and should augment clinician counsel regarding complementary medicine administration, especially in high-risk individuals like those with cancer.
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