Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh
There are a growing number of cases detailing acute hepatic necrosis in patients taking black cohosh (Cimicifuga racemosa), an over-the-counter herbal supplement for management of menopausal symptoms. Our aim is to illustrate two cases of liver injury following the use of black cohosh characterized...
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| Format: | Article |
| Language: | English |
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Wiley
2009-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2009/918156 |
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| _version_ | 1832555142007750656 |
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| author | Grace Guzman Eric R. Kallwitz Christina Wojewoda Rohini Chennuri Jamie Berkes Thomas J. Layden Scott J. Cotler |
| author_facet | Grace Guzman Eric R. Kallwitz Christina Wojewoda Rohini Chennuri Jamie Berkes Thomas J. Layden Scott J. Cotler |
| author_sort | Grace Guzman |
| collection | DOAJ |
| description | There are a growing number of cases detailing acute hepatic necrosis in patients taking black cohosh (Cimicifuga racemosa), an over-the-counter herbal supplement for management of menopausal symptoms. Our aim is to illustrate two cases of liver injury following the use of black cohosh characterized by histopathological features mimicking autoimmune hepatitis. Both patients reported black cohosh use for at least six months and had no evidence of another cause of liver disease. Their liver biopsies showed a component of centrilobular necrosis consistent with severe drug-induced liver injury. In addition, the biopsies showed characteristics of autoimmune-like liver injury with an interface hepatitis dominated by plasma cells. Although serum markers for autoimmune hepatitis were not particularly elevated, both patients responded to corticosteroids, supporting an immune-mediated component to the liver injury. Liver injury following the use of black cohosh should be included in the list of differential diagnoses for chronic hepatitis with features mimicking autoimmune hepatitis. |
| format | Article |
| id | doaj-art-e7ec1759e5ce486f8aef667e8c8db64d |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2009-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-e7ec1759e5ce486f8aef667e8c8db64d2025-02-03T05:49:36ZengWileyCase Reports in Medicine1687-96271687-96352009-01-01200910.1155/2009/918156918156Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black CohoshGrace Guzman0Eric R. Kallwitz1Christina Wojewoda2Rohini Chennuri3Jamie Berkes4Thomas J. Layden5Scott J. Cotler6Department of Pathology, University of Illinois, Chicago, IL 60612, USADepartment of Medicine, University of Illinois, Chicago, IL 60612, USADepartment of Pathology, Case Western Reserve University, Cleveland, OH 44106, USADepartment of Pathology, University of Illinois, Chicago, IL 60612, USADepartment of Medicine, University of Illinois, Chicago, IL 60612, USADepartment of Medicine, University of Illinois, Chicago, IL 60612, USADepartment of Medicine, University of Illinois, Chicago, IL 60612, USAThere are a growing number of cases detailing acute hepatic necrosis in patients taking black cohosh (Cimicifuga racemosa), an over-the-counter herbal supplement for management of menopausal symptoms. Our aim is to illustrate two cases of liver injury following the use of black cohosh characterized by histopathological features mimicking autoimmune hepatitis. Both patients reported black cohosh use for at least six months and had no evidence of another cause of liver disease. Their liver biopsies showed a component of centrilobular necrosis consistent with severe drug-induced liver injury. In addition, the biopsies showed characteristics of autoimmune-like liver injury with an interface hepatitis dominated by plasma cells. Although serum markers for autoimmune hepatitis were not particularly elevated, both patients responded to corticosteroids, supporting an immune-mediated component to the liver injury. Liver injury following the use of black cohosh should be included in the list of differential diagnoses for chronic hepatitis with features mimicking autoimmune hepatitis.http://dx.doi.org/10.1155/2009/918156 |
| spellingShingle | Grace Guzman Eric R. Kallwitz Christina Wojewoda Rohini Chennuri Jamie Berkes Thomas J. Layden Scott J. Cotler Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh Case Reports in Medicine |
| title | Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh |
| title_full | Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh |
| title_fullStr | Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh |
| title_full_unstemmed | Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh |
| title_short | Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh |
| title_sort | liver injury with features mimicking autoimmune hepatitis following the use of black cohosh |
| url | http://dx.doi.org/10.1155/2009/918156 |
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