Herb-Induced Liver Injury by Ayurvedic Medicine With Severe Lactic Acidosis: A Case Report
Authors
Deepak Sharma
Critical Care Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, GBR
Ahmed Ahmed
Anesthesia and Critical Care Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, GBR
Ali Razak
Anesthesia and Critical Care Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, GBR
Priyanka Sharma
Research and Development, University of Birmingham, Birmingham, GBR
Keywords:
critical care and hospital medicine, herbal-induced liver injury (hili), drug-induced liver injury (dili), rucam score, ayurvedic medicine
Abstract
Lactate is the basic blood parameter in the arsenal of an intensivist when managing a critically ill patient. A 62-year-old male presented with nausea and vomiting. He had been using an Ayurvedic medication, Insulin Management Expert (IME-9), for his type 2 diabetes mellitus and was found to have severe lactic acidosis that was resistant to initial fluid resuscitation and Ayurvedic medicine-induced liver injury. He required admission to critical care for organ support and ultimately recovered. Because current literature on the adverse effects of this Ayurvedic medication, particularly hepatotoxicity, is limited, causality was determined using the adverse drug association tool Roussel Uclaf Causality Assessment Method (RUCAM), which determined this as a probable cause with a strong score of seven. As a result, our case adds a vital gear to the wheel of current research literature.
Keywords: critical care and hospital medicine, herbal-induced liver injury (hili), drug-induced liver injury (dili), rucam score, ayurvedic medicine
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