Senadhi V, Arora D, Arora M, Marsh F. A rare cause of drug-induced hepatitis in an immunocompromised patient and the role of glutathione. World J Hepatol 2012; 4(8): 248-251 [PMID: 22993667 DOI: 10.4254/wjh.v4.i8.248]
Corresponding Author of This Article
Dr. Viplove Senadhi, Department of Gastroenterology and Hepatology, Indiana University School of Medicine, 1050 Wishard Blvd, RG 4100, Indianapolis, IN 46202, United States. vsenadhi@hotmail.com
Article-Type of This Article
Case Report
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World J Hepatol. Aug 27, 2012; 4(8): 248-251 Published online Aug 27, 2012. doi: 10.4254/wjh.v4.i8.248
A rare cause of drug-induced hepatitis in an immunocompromised patient and the role of glutathione
Viplove Senadhi, Deepika Arora, Manish Arora, Franklin Marsh
Viplove Senadhi, Division of Gastroenterology and Hepatology and Brater Scholar, Indiana Institute for Personalized Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States
Deepika Arora, Elmhurst Hospital/Mount Sinai School of Medicine, New York City, New York, NY 10005, United States
Manish Arora, Division of Gastroenterology and Hepatology, University of Maryland and National Institute of Health, Baltimore/Washington DC, MD 21742, United States
Franklin Marsh, Division of Gastroenterology and Hepatology, New York Hospital-Weill Cornell Medical Center, New York City, New York, NY 10005, United States
Author contributions: Senadhi V wrote the entire manuscript, performed the literature review, including all references, incorporated it into the manuscript, modified the initial abstract to its final form, modified a poster presentation to its final form, including the table and performed all revisions and editing of the paper; Arora D wrote the initial abstract, constructed the table, created and presented the final poster presentation; Arora M also reviewed the manuscript and incorporated suggestions throughout the abstract and manuscript process; Marsh F was the mentor author and incorporated suggestions throughout the abstract/manuscript process.
Correspondence to: Dr. Viplove Senadhi, Department of Gastroenterology and Hepatology, Indiana University School of Medicine, 1050 Wishard Blvd, RG 4100, Indianapolis, IN 46202, United States. vsenadhi@hotmail.com
Telephone: +1-317-2780402 Fax: +1-678-6235999
Received: January 14, 2011 Revised: June 28, 2012 Accepted: August 23, 2012 Published online: August 27, 2012
Abstract
The Food and Drug Administration (FDA) has issued a warning on numerous herbal drugs, including many popular products at General Nutrition Centers (GNC), regarding unstudied hepatotoxicity. There have been recent reports of GNC products such as hydroxycut and herbalife, causing drug-induced hepatitis. Herbal medications are over-the-counter products and are not investigated thoroughly by the FDA. Given that the most common outpatient laboratory abnormality is elevated liver transaminases, a sign of hepatocellular toxicity; it is not surprising that some of these products end up causing hepatic dysfunction, especially when taken in large volume. There are numerous herbal supplements that are hepatotoxic, however, these medications have a much more significant effect in human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome patients, which is secondary to depleted glutathione. We present a rare case of drug induced hepatitis secondary to herbal medications used to treat HIV and elucidate the role of glutathione depletion in immunocompromised patients.
