A case of acute interstitial nephropathy and toxic hepatitis after short-term herbal medication / 대한내과학회지

ABSTRACT

There are many kinds of herbal medication available in Korea, and some of them have been reported to be related with renal failure. However, the simultaneous occurrence of toxic hepatitis and acute renal failure associated with herbal medicine has rarely been reported. A 26-year-old male was admitted with a sudden onset of jaundice and generalized weakness after taking two doses of herbal medication. A physical examination revealed no abnormalities other than scleral icterus. The patient's blood chemistry demonstrated a blood urea nitrogen level of 91 mg/dL, a creatinine level of 13 mg/dL, an AST of 212 IU/L, an ALT of 1,528 IU/L and a bilirubin level of 8.5 mg/dL. Renal biopsy showed interstitial edema and an infiltration of neutrophils and lymphocytes with preserved glomeruli and vascular structure; these findings were consistent with administering medical supportive care without renal replacement therapy. He was discharged on the 8th hospital day. This case provides the possibility of development of hepatitis and renal failure due to herbal medication. We propose that a meticulous history taking for determining the herbal medications a patient has taken should be done for those cases of simultaneous toxic hepatitis and renal failure that are without any obvious cause in Korea.