ABSTRACT
Case reports of drug-induced liver injury caused by Kampo medicines are on the rise, but most of them are noted for related symptoms such as jaundice. Usually, severe liver injury is detected by chance upon routine medical checkup. Recently, we noted 3 cases of suspected drug-induced liver injury caused by orengedokuto, saikokeishikankyoto and bofutsushosan. In these 3 cases, maximum ALT was under 100 IU/l and no symptoms related to liver injury were observed. Early detection by blood test was useful, and appropriate treatment quickly improved and normalized the abnormal values associated with liver injury. We should always be alert for drug-induced liver injury caused by Kampo medicines, especially when prescribing formulations that include <i>Scutellariae Radix</i>. We also emphasize the importance of scheduling blood tests when prescribing these formulations.
ABSTRACT
We report a patient with hemifacial spasm in whom daijokito was effective. The patient was a 57-year-old woman who visited our clinic for treatment of fatty liver and asthma. She had been suffering from left blepharospasm and paroxysmal twitching movement of the left lower jaw in stressful situations during the 2 years prior to her first visit to us. After we prescribed daijokito because of her pot belly, she had no more asthma attacks and her left facial spasm improved. Seven months later, we added inchinko to daijokito for her liver damage. When we followed the test results of her clinical survey for two years, we found that her weight had decreased and liver function was improved after starting this dosage. We diagnosed her paroxysmal involuntary twitching on the left side of the face as hemifacial spasm, because these symptoms were unilateral. We regard that her hemifacial spasm was improved with relaxation, anticonvulsants, and the antianxiety action of daijokito.
ABSTRACT
We report a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) in whom saikanto was effective against pleural effusion induced by dasatinib, which is a second-generation tyrosine kinase inhibitor. The patient was a 43-year-old female. After she was diagnosed with Ph+ALL, she received imatinib and other chemotherapy. One year later, she started to receive dasatinib because of imatinib intolerance (vomiting and diarrhea). After about seven months of taking dasatinib, she experienced chest/back pain and a cough; at that time her chest x-ray showed right-sided pleural effusion. She consulted our clinic three months later, for treatment of the hydrothorax that frequently recurred. We prescribed saikanto because she presented with epigastric tenderness diagnosed as <i>shokekkyo</i>, and the pleural effusion and clinical symptoms improved remarkably. Because of the good clinical course in this case, we consider that the decrease of pleural effusion was caused mainly by the immunoregulatory and anti-inflammatory activities of saikanto in addition to its activities to alleviate fluid retention.