Philips Cyriac Abby, Ahamed Rizwan, Abduljaleel Jinsha K, Rajesh Sasidharan, Theruvath Arif Hussain, Raveendran Resmi, Augustine Philip
Clinical and Translational Hepatology & Monarch Liver Laboratory, The Liver Institute, Center of Excellence in GI Sciences, Rajagiri Hospital, Aluva, Kerala, India.
Gastroenterology & Advanced GI Endoscopy, Center of Excellence in GI Sciences, Rajagiri Hospital, Aluva, Kerala, India.
Oxf Med Case Reports. 2022 Oct 22;2022(10):omac113. doi: 10.1093/omcr/omac113. eCollection 2022 Oct.
We report a novel and as yet undescribed clinical scenario in a young girl with liver failure, in whom, the liver histopathology was suggestive of alcoholic hepatitis in the background of hepatoportal sclerosis and incomplete septal cirrhosis. An extensive clinical and investigational evaluation revealed chronic consumption of multiple Ayurvedic herbal medications for seizure disease. Six months after stopping herbal medicines, the repeat liver biopsy demonstrated resolution of alcohol-related changes but persistence of classical features of non-cirrhotic portal hypertension. Analysis of the retrieved agents, including state of the art chemical and toxicology analysis, using gas chromatography and mass spectroscopy methods demonstrated multiple organic and inorganic toxins associated with acute alcohol and arsenic poisoning related hepatoportal sclerosis/incomplete septal cirrhosis in the young girl.
我们报告了一名患有肝衰竭的年轻女孩的一种新颖且尚未描述的临床情况,其肝脏组织病理学提示在肝门脉硬化和不完全间隔性肝硬化背景下存在酒精性肝炎。广泛的临床和调查评估显示,该女孩长期服用多种用于治疗癫痫疾病的阿育吠陀草药。停用草药六个月后,再次进行肝脏活检显示与酒精相关的变化有所缓解,但非肝硬化性门静脉高压的典型特征依然存在。使用气相色谱和质谱法对所提取的药物进行分析,包括最先进的化学和毒理学分析,结果表明该年轻女孩体内存在多种与急性酒精和砷中毒相关的有机和无机毒素,这些毒素与肝门脉硬化/不完全间隔性肝硬化有关。