SHM Converge Scientific Abstract ePoster Gallery-Turmeric-Induced Liver Injury in a Patient With Concurrent Semaglutide Use

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This case report describes a 70-year-old woman with multiple chronic conditions who developed severe acute liver injury after starting both semaglutide for weight loss and turmeric supplements for rheumatoid arthritis about two months earlier. She presented with two weeks of nausea, jaundice, dark urine, loss of appetite, and clay-colored stools. Exam showed scleral icterus, palmar erythema, and jaundice without encephalopathy or ascites.<br /><br />Initial labs revealed marked liver dysfunction, with AST 912 U/L, ALT 999 U/L, alkaline phosphatase 409 U/L, and total bilirubin 20.5 mg/dL. Imaging showed cholelithiasis and gallbladder wall thickening but no bile duct obstruction. MRI suggested a slightly nodular liver contour, but there was no focal lesion. Extensive workup for viral, autoimmune, metabolic, toxic, and hereditary causes of liver disease was negative. A liver biopsy showed findings consistent with cholestatic hepatitis, including lobular fibrosis, inflammatory infiltrates, and hepatocytic injury.<br /><br />The authors conclude that drug-induced liver injury was the most likely diagnosis after exclusion of other causes. They propose turmeric as the primary culprit, with possible contribution from semaglutide. They also note that some turmeric formulations include piperine (black pepper extract), which can greatly increase curcumin absorption and may raise toxicity risk. In addition, semaglutide and turmeric may have interacted through the NF-κB pathway, potentially worsening inflammation and liver injury.<br /><br />The report emphasizes the growing concern for turmeric-induced liver injury, the need for careful review of herbal and dietary supplements during medication reconciliation, and the importance of stronger regulation and safety evaluation of supplement ingredient combinations.

Asset Subtitle

Emily J. Zhang

Meta Tag

Author List Elona Poltiyelova, Emily J. Zhang, Mitra Rezvani

Category Clinical Vignettes

Concept Drug-Induced Liver Injury

Concept Acute Liver Injury

Concept Medication Reconciliation

Concept Cholestatic Hepatitis

Concept Diagnosis of Exclusion

Distinguished Non-Finalist

Presenter Organization New York Medical College

Presenting Author Emily J. Zhang

Track Adult

Keywords

drug-induced liver injury

turmeric

semaglutide

acute liver injury

cholestatic hepatitis

rheumatoid arthritis

piperine

curcumin

hepatotoxicity

herbal supplements

Drug-Induced Liver Injury

Acute Liver Injury

Medication Reconciliation

Cholestatic Hepatitis

Diagnosis of Exclusion