Liver injury induced by raw polygonum multiflorum medicinal wine

Abstract

A 33-year-old male patient drank raw polygonum multiflorum medicinal wine (prepared by raw polygonum multiflorum 500 g+ 40% wine 1 000 ml) 50 ml/d to invigorate Yang. Four weeks later, he developed abdominal distension. Six weeks later, he developed yellow urine. Seven weeks later, he developed pruritus, dyspepsia and fatigue. The wine was stopped by himself. One week later, laboratory examination showed the following results: alanine aminotransferase 1 406 U/L, aspartate aminotransferase 546 U/L, gamma-glutamyl transpeptidase 203 U/L, total bilirubin 204.0 μmol/L, direct bilirubin 159.6 μmol/L, alkaline phosphatase 195 U/L, total bile acid 228 μmol/L, and C-reactive protein 10.5 mg/L. Abdominal CT showed signs of fatty liver, abnormal strengthened focus in left inner lobe of the liver and cholecystitis. The patient was treated with IV infusions of compound glycyrrhizin 100 mg, glutathione 1.8 g/d and polyene phosphatidylcholine 697.5 mg once daily. Two weeks later, a liver biopsy was performed, the hepatic pathology showed changes indicating acute drug-induced liver injury. Liver-protective treatments were continued. Eleven days later, laboratory tests showed alanine aminotransferase 43 U/L, aspartate aminotransferase 19 U/L, gamma-glutamyl transpeptidase 61 U/L, total bilirubin 29.0 μmol/L, direct bilirubin 22.3 μmol/L, alkaline phosphatase 88 U/L, total bile acid 17 μmol/L. Key words: Polygonum multiflorum; Drug-induced liver injury