SHM Converge Scientific Abstract ePoster Gallery-Missed in the Medication List: Fo-Ti Induced Hepatitis Reveals a Diagnostic Gap

Pdf Summary

This case highlights a 52-year-old woman who presented with several weeks of pruritus, dark urine, and scleral icterus, with markedly elevated liver enzymes and bilirubin consistent with severe hepatocellular injury. Initial workup for common causes of acute hepatitis was unrevealing, including negative infectious testing, unremarkable autoimmune evaluation, and negative imaging studies.<br /><br />The key diagnostic clue was later identification of daily Fo-Ti (He Shou Wu) use as an over-the-counter hair supplement for one year, which had been omitted from the medication list. After stopping Fo-Ti, her symptoms improved and liver tests normalized within six weeks, supporting herb-induced liver injury (HILI) as the cause.<br /><br />The report emphasizes that herbal supplements are commonly missed during medication reconciliation and should be specifically assessed in patients with unexplained transaminitis or jaundice. Fo-Ti is widely used for hair growth and anti-aging, especially among middle-aged women, but has been linked to hepatotoxicity. Risk may vary by product type, preparation method, anthraquinone content, and possibly genetic susceptibility.<br /><br />Overall, the case underscores the importance of routinely asking about nonprescription supplements in hospital and outpatient settings. Recognition of HILI depends on excluding other etiologies, identifying a temporal relationship between exposure and injury, and observing improvement after discontinuation.

Asset Subtitle

Chinmayi Sharma

Meta Tag

Author List Chinmayi Sharma, Prashanth Bhat, Sahil Bangar, Samantha Gutierrez, Yash Patel, Zaheer Choudhury

Category Clinical Vignettes

Concept Herb-Induced Liver Injury

Concept Fo-Ti

Concept Herbal Supplement Use

Concept Hepatotoxicity

Concept Aminotransferase Elevation

Distinguished Non-Finalist

Presenter Organization Baptist Memorial Hospital

Presenting Author Chinmayi Sharma

Track Adult

Keywords

Fo-Ti

He Shou Wu

herb-induced liver injury

hepatotoxicity

jaundice

transaminitis

herbal supplements

pruritus

scleral icterus

medication reconciliation

Herb-Induced Liver Injury

Fo-Ti

Herbal Supplement Use

Hepatotoxicity

Aminotransferase Elevation