Kunal Dalal
Department of Medicine, Cooper Medical School of Rowan University, Cooper University Hospital, Camden, NJ 08103, United States. [email protected]
Thomas Holdbrook
Department of Pathology, Cooper Medical School of Rowan University, Cooper University Hospital, Camden, NJ 08103, United States
Steven Peikin
Division of Gastroenterology and Liver Disease, Cooper Medical School of Rowan University, Cooper University Hospital, Camden, NJ 08103, United States
Drug induced liver injury is responsible for 50% of acute liver failure in developed countries. Ayurvedic and homeopathic medicine have been linked to liver injury. This case describes the first documented case of Punarnava mandur and Kanchnar guggulu causing drug induced liver injury. Drug induced liver injury may be difficult to diagnosis, but use of multi-modalities tools including the ACG algorithms, causative assessment scales, histological findings, and imaging, is recommended. Advanced imaging, such as magnetic resonance cholangiopancreatography, may possibly have a greater role than previously reported in literature.
Keywords: Ayurvedic, Punarnava mandur, Kanchnar guggulu, Drug induced liver injury, T2 heterogeneous hyperintensity, Roussel Uclaf Causality Assessment Method
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