摘要
Lesser celandine, also known as Ranunculus ficaria, is a herbaceous perennial plant that commonly utilizes piles and is taken either internally or used externally.The causality assessment of several reports provided evidence for the existence of Greater Celandine hepatotoxicity. However, there hasn't been any case report published thus far, about lesser celandine induced liver injury. Here, we present a case of 36-year-old woman admitted to the hospital with acute hepatitis and jaundice on her sclera with no history of drug abuse or alcohol consumption. However, the patient had a recent history of lesser celandine extract consumption for hemorrhoids, for about 10 d, prior to the admission. Viral hepatitis, autoimmune hepatitis, and drug induced toxic hepatitis were ruled out by further imaging studies and laboratory analysis. Using the Council for International Organizations of Medical Sciences scale, the type of liver injury was assumed as hepatocellular and was scored as 7 which shows probable causality. Immediate discontinuation of lesser celandine extract resulted in rapid decrease of the elevated enzymes. Herbs have been reported to cause liver injury and therefore should be suspected in the case of acute hepatitis with an unknown etiology. This case is important to be the first to explain hepatotoxicity caused by lesser celandine. Physicians should consider lesser celandine as a causative agent for hepatotoxicity.
Lesser celandine, also known as Ranunculus ficaria , isa herbaceous perennial plant that commonly utilizespiles and is taken either internally or used externally.The causality assessment of several reports providedevidence for the existence of Greater Celandinehepatotoxicity. However, there hasn＇t been any casereport published thus far, about lesser celandineinduced liver injury. Here, we present a case of36-year-old woman admitted to the hospital with acutehepatitis and jaundice on her sclera with no historyof drug abuse or alcohol consumption. However, thepatient had a recent history of lesser celandine extractconsumption for hemorrhoids, for about 10 d, prior tothe admission. Viral hepatitis, autoimmune hepatitis,and drug induced toxic hepatitis were ruled out byfurther imaging studies and laboratory analysis. Usingthe Council for International Organizations of MedicalSciences scale, the type of liver injury was assumedas hepatocellular and was scored as 7 which showsprobable causality. Immediate discontinuation of lessercelandine extract resulted in rapid decrease of theelevated enzymes. Herbs have been reported to causeliver injury and therefore should be suspected in thecase of acute hepatitis with an unknown etiology. Thiscase is important to be the first to explain hepatotoxicitycaused by lesser celandine. Physicians should considerlesser celandine as a causative agent for hepatotoxicity.
