Liver failure associated with mahogany seed extract consumption
A 45-year-old woman presented to the emergency department with jaundice of 2 weeks’ duration. This was associated with mahogany seed extract (Skyfruit supplement) consumption for 6 months prior to admission. Examination was normal apart from scleral icterus and grade 2 encephalopathy. Liver function...
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| creator | Yeap, Valerie Tan, Terence Jin Yang Loh, Tracy Kumar, Rajneesh |
| description | A 45-year-old woman presented to the emergency department with jaundice of 2 weeks’ duration. This was associated with mahogany seed extract (Skyfruit supplement) consumption for 6 months prior to admission. Examination was normal apart from scleral icterus and grade 2 encephalopathy. Liver function tests showed a hepatocellular pattern of derangement: alanine transaminase, 1267 U/L (10–36); aspartatetransaminase, 1255 U/L (10–30); alkaline phosphatase, 124 U/L (22–104); bilirubin, 258 µmol/L (3–21) with a prolonged prothrombin time of 16.8 s (9.2–11.0). Viral hepatitis work-up was largely unremarkable and liver biopsy showed moderate inflammatory infiltrates (mostly lymphocytic with scattered eosinophils) in the periportal region and lobule with bridging necrosis, favouring drug-induced liver injury. Withdrawal of the drug resulted in normalisation of liver function. |
| doi_str_mv | 10.1136/bcr-2018-225382 |
| format | Article |
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This was associated with mahogany seed extract (Skyfruit supplement) consumption for 6 months prior to admission. Examination was normal apart from scleral icterus and grade 2 encephalopathy. Liver function tests showed a hepatocellular pattern of derangement: alanine transaminase, 1267 U/L (10–36); aspartatetransaminase, 1255 U/L (10–30); alkaline phosphatase, 124 U/L (22–104); bilirubin, 258 µmol/L (3–21) with a prolonged prothrombin time of 16.8 s (9.2–11.0). Viral hepatitis work-up was largely unremarkable and liver biopsy showed moderate inflammatory infiltrates (mostly lymphocytic with scattered eosinophils) in the periportal region and lobule with bridging necrosis, favouring drug-induced liver injury. Withdrawal of the drug resulted in normalisation of liver function.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2018-225382</identifier><identifier>PMID: 30061133</identifier><language>eng</language><publisher>England: BMJ Publishing Group</publisher><subject>Findings That Shed New Light on the Possible Pathogenesis of a Disease or an Adverse Effect</subject><ispartof>BMJ case reports, 2018-07, Vol.2018, p.bcr-2018-225382</ispartof><rights>BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. 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| title | Liver failure associated with mahogany seed extract consumption |
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