DOI 10.5414/CP201835

Int. Journal of Clinical Pharmacology and Therapeutics, Volume 51 - March (219 - 223)

Drug-induced acute liver injury mimicking autoimmune hepatitis after intake of dietary supplements containing glucosamine and chondroitin sulfate

Johann von Felden1, Matteo Montani2, Kerstin Kessebohm3, Felix Stickel1
1 Department of Visceral Surgery, Medicine, Inselspital, 2 Institute of Pathology, 3 Center for Clinical Pharmacology, Pharmacovigilance, University of Berne, Switzerland

Abstract

Introduction: Herbal and dietary supplements are widely used as measures to improve and preserve health and well-being. Among the bestselling preparations are dietary supplement containing glucosamine and chondroitine sulfate taken to improve symptoms of osteoarthritis. Methods and results: We here present a case of a male patient with biopsy-proven acute and severe autoimmune hepatitis subsequent to intake of a preparation containing glucosamine and chondroitine sulfate. Response to steroids was favorable and resulted in complete remission of the patient. Diagnostic work-up of the case revealed no other possible cause of liver injury, and causality assessment using the Roussel Uclaf Causality Assessment Method (RUCAM) resulted in a possible causal relationship between intake of glucosamine and chondroitine sulfate and the adverse hepatic reaction. Conclusion: The present case recalls that products containing glucosamine and chondroitine sulfate can occasionally cause acute liver injury mimicking autoimmune hepatitis, and reminds of the potential dangers of compounds with poor efficacy and ill-defined safety records.

Author Details

Authors

  • Johann von Felden1
  • Matteo Montani2
  • Kerstin Kessebohm3
  • Felix Stickel1

Departments

  • 1 Department of Visceral Surgery, Medicine, Inselspital,
  • 2 Institute of Pathology,
  • 3 Center for Clinical Pharmacology, Pharmacovigilance, University of Berne, Switzerland

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