SHM Converge Scientific Abstract ePoster Gallery-A Case of Drug Induced Liver Injury Secondary to Turmeric Supplementation

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A 69-year-old man with no significant past medical history presented with severe itching and jaundice. He had recently traveled to Mexico and had started taking a turmeric supplement. On exam, he was diffusely jaundiced with scleral icterus but had no abdominal tenderness or edema.<br /><br />Initial labs showed an elevated liver panel consistent with liver injury (AST 241, ALT 95, alkaline phosphatase 66, total bilirubin 13). CT abdomen/pelvis showed only hepatic steatosis. Workup for infectious and autoimmune causes was largely negative, including HIV, EBV, HAV, HBV, HCV, anti-smooth muscle antibody, and antimitochondrial antibody, though ANA was positive at 1:160. Because no obstructive cause was found, turmeric was stopped and symptom-directed treatment was started. MRCP was negative for biliary obstruction, and a liver biopsy was performed. Ursodiol and cholestyramine were added, and the patient improved clinically by day 3 with downtrending liver tests and was discharged.<br /><br />Outpatient biopsy confirmed drug-induced liver injury (DILI) secondary to turmeric supplementation. Over the following three months, his liver tests normalized.<br /><br />This case highlights that turmeric and other herbal supplements can cause clinically significant DILI. Although many cases improve after stopping the offending agent, severe presentations can occur and require close monitoring.

Asset Subtitle

Andrew L. Wu

Meta Tag

Author List Andrew L. Wu, Ziad Sad Aldeen

Category Clinical Vignettes

Concept Drug-Induced Liver Injury

Concept Turmeric

Concept Offending Agent

Concept Jaundice

Concept Pruritus

Distinguished Non-Finalist

Presenter Organization University of Wisconsin

Presenting Author Andrew L. Wu

Track Adult

Keywords

turmeric

drug-induced liver injury

DILI

jaundice

pruritus

herbal supplement

cholestasis

liver biopsy

ursodiol

cholestyramine

Drug-Induced Liver Injury

Turmeric

Offending Agent

Jaundice

Pruritus