A unique case of autoimmune hepatitis: Can dietary weight-loss supplements act as toxin-induced precipitants?

Abstract

Introduction: Dietary and weight loss supplements have been shown to cause acute hepatitis through toxic liver injury. Herein, we present a case of a woman who was found to have both acute hepatitis and autoimmune hepatitis (AIH) in the setting of ingesting a popular weight loss supplement, Hydroxycut®. Case Report: A 29-year-old female without significant past medical history presented to our hospital with three weeks of abdominal pain, decreased appetite and jaundice. She intentionally lost 15 pounds in the last four months using two weight loss supplements, Hydroxycut and Herbalife. Initial lab work at her primary care physician’s office revealed AST of 2409 U/L, ALT of 2000 U/L, TBili of 15.1 md/dL. She was advised to go to the emergency room given her physician’s concern for liver injury. In the hospital, her vital signs were within normal limits (WNL) and her physical exam revealed jaundice, scleral icterus and mild epigastric tenderness, without encephalopathy. After other etiologies of acute hepatitis were ruled out, autoimmune panels were ordered which revealed an elevated