A case series of drug induced liver injury leading to ACLF after complementary & alternative medicine over-use for COVID-19
Journal of Clinical and Experimental Hepatology
; 12:S45, 2022.
Article
in English
| EMBASE | ID: covidwho-1977436
ABSTRACT
Background and Aims:
ACLF is a condition in which 2 insults to liver operate simultaneously, 1 being chronic, and other acute. Complementary & alternative medicine (CAM) are important causes for ACLF. India is the birth place of Ayurveda & CAM is considered safe by the common population with around 80% of the population relying on it. CAM consumption has increased in recent years. Due to the pandemic and the focus on improved immunity, the consumption of CAM has gone up. India has reported 4.8 lakh COVID 19 related deaths till December 2021. However, WHO has estimated 4.7 million deaths directly or indirectly related to COVID-19. We documented a case series of CAM related DILI-ACLF, with CAM being consumed for COVID preventionMethods:
ACLF established with APASL defining criteria. USG was done to assess for features of CLD. Liver biopsy was done where feasible.Results:
Case 1-39-year-old diabetic taking Giloy Kwath for 2 months for COVID prevention. Presenting with jaundice & ascites having MELD score 18 and CTP class B, he had NASH related cirrhosis on biopsy and is still on follow up. Case 2- f/u/c of CTP A alcoholic cirrhosis who consumed a crushed herb for protection against COVID given by a quack for 3 months, with no alcohol intake in 2 years. He presented with jaundice and encephelopathy, had MELD score 38 & CTP C & succumbed to illness. Case 3 49-year-old lady consuming Giloy Kwath for 4 months for COVID prevention. She was diagnosed with AIH type 1 with MELD score 39. She succumbed to illness with post-mortem liver biopsy showed features of AIH cirrhosisConclusion:
CAM is the most common cause of drug induced ACLF. CAM consumption increased during the pandemic and may have lead to increase in indirect COVID related deaths
acute on chronic liver failure; adult; adverse drug reaction; alcohol consumption; alcohol liver cirrhosis; alternative medicine; ascites; case report; case study; clinical article; conference abstract; coronavirus disease 2019; diabetes mellitus; drug overdose; drug-induced liver injury; female; follow up; human; immunity; India; jaundice; liver biopsy; liver cirrhosis; male; Model For End Stage Liver Disease Score; nonhuman; pandemic; prevention; quackery; side effect; Tinospora cordifolia
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Topics:
Traditional medicine
Language:
English
Journal:
Journal of Clinical and Experimental Hepatology
Year:
2022
Document Type:
Article
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