산괴불주머니에 의한 급성 독성간염 1예
A case of acute cholestatic hepatitis induced by Corydalis speciosa Max.
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초록
산괴불주머니라는 약초에 의한 급성 독성간염의 1예를 보고하고자 한다. 환자는 상기 약초를 다려 먹은 후 황달이 발생하여 입원하였으나 약초로 인한 간손상이라고는 생각하지 않아 병력 청취 시 말하지 않았고, 결국 원인 규명은 이루어지지 못한 채 간손상이 호전되어 퇴원하였다. 그러나 퇴원 후 약초 재복용으로 인해 간손상이 악화되면서 비로소 복용 사실을 언급하였고 약인성 독성간염으로 확진하게 되었다. 약인성 간손상에서 복용 약물의 인지가 늦어지면 진단이 늦어질 뿐 아니라 재발의 가능성이 높아지므로 약물 사용력에 대해 보다 세밀한 조사가 필요할 것으로 생각한다.
Abstract
Herbs are widely used as treatments for various symptoms. However, several herbs have been reported to be inducers of liver injury. We report herein a case of hepatotoxicity induced by Corydalis speciosa Max. A 37-year-old male complained of jaundice and mild abdominal discomfort. A thorough history was taken, and laboratory investigation, diagnostic imaging studies, and percutaneous liver biopsy sampling were conducted to determine the cause of liver injury. An accurate cause was not revealed. We administered supportive management for acute cholestatic hepatitis of unknown origin, after which his symptoms disappeared and serum aminotransferase levels decreased gradually to near normal levels. However, at 2 months after discharge, the symptoms and the elevation of aminotransferase levels recurred. At that time he told us that he had repeatedly but unintentionally eaten a herb called “Hwang-geun cho”(Corydalis speciosa Max.). Thus, we diagnosed his case as herbal hepatotoxicity.
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