Abstract
A 36-year-old woman developed fatigue, anorexia, and yellowish skin after taking Paiduyangyan capsule by herself for a month. Liver function tests showed the following results: alanine aminotransferase (ALT) 1 032 U/L, aspartate aminotransferase (AST) 602 U/L, total bilirubin (TBil) 61.7 μmol/L, direct bilirubin (DBil) 45 μmol/L, γ-glutamyl transferase (γ-GT) 148 U/L, alkaline phosphatase (ALP) 140 U/L. Paidugangyan capsule was stopped and liver-protective treatments were given but there were no marked treatment effects. The levels of above mentioned parameters increased continuously and anti nuclear antibody (ANA) level increased one month after the onset of the liver injury. The highest titer of ANA was >1 ∶ 1 000. Liver biopsy result suggested that the liver injury was caused by drugs. Four and a half months after the onset of liver injury, the patient received prednisolone (initial dose was 60 mg once daily and then the dose was gradually reduced). After 3 months of prednisolone treatment, the patient's liver function parameters returned to normal. After 7 months of prednisolone treatment, the patient's ANA level returned to normal and all symptoms disappeared. After 7 and a half months of treatment, prednisolone was stopped. The symptoms did not recur at 7 years of follow-up. Key words: Drug induced liver injury; Hepatitis, autoimmune; Paiduyangyan capsule
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