A case of drug-induced liver damage caused by Sho-saiko-to.

Kadota, Yoichi; Fujinami, Shigeru; Fukui, Yusuke; Tagawa, Yoshihiro; Nakagawa, Taiichi; Wakabayashi, Masayuki; Takeuchi, Yukitoshi; Shiro, Tomohiro; Y, Kawashima; Okuno, Hiroyasu; Seki, Toshihito; Shiozaki, Yasuko; Inoue, Katsumi; Okamura, Atsushi

doi:10.2957/kanzo.34.36

Cited by 5 publications

(5 citation statements)

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“…To diagnose drug-induced liver injury, the challenge test provides a definitive etiologic diagnosis. There have been multiple reports of cases in which small doses of a Kampo formula containing Scutellariae Radix were challenged as the causal drug and resulted in positive findings ( 7 , 8 , 14 ). However, at present, the challenge test is generally not recommended, as it is accompanied by risk.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Drug-induced Liver Injury Caused by the Incidental Readministration of a Kampo Formula Containing Scutellariae Radix

et al. 2018

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A 67-year-old woman experiencing coughing visited a clinic and was prescribed drugs, including shosaikoto extract, for 4 days. She subsequently suffered from liver injury, but her condition improved after the discontinuation of all medications. Approximately 1 year later, she experienced fatigue, consulted another clinic, and received saikokeishikankyoto extract for 21 days. She subsequently suffered liver injury again. Both shosaikoto and saikokeishikankyoto contain Scutellariae Radix. This case is thought to be one of recurrent drug-induced liver injury caused by the incidental readministration of a Kampo formula containing Scutellariae Radix. An awareness of adverse drug events caused by Kampo formulas, especially those containing Scutellariae Radix, is essential.

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Section: Discussionmentioning

confidence: 99%

Recurrent Drug-induced Liver Injury Caused by the Incidental Readministration of a Kampo Formula Containing Scutellariae Radix

et al. 2018

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“…According to an analysis of 1,676 cases of drug-induced liver injury occurring between 1997 and 2006 conducted by the Japan Society of Hepatology, causal drugs were narrowed down to a single drug in 879 cases; 7.1% of them were Kampo medicines [6]. Furthermore, there have been many case reports of liver injury induced by Kampo formulas that contain Scutellariae Radix [14–18]. We also reported a case of recurrent drug-induced liver injury caused by the incidental readministration of a Kampo formula containing Scutellariae Radix [19].…”

Section: Resultsmentioning

confidence: 99%

“…The challenge test provides a definitive etiologic diagnosis of drug-induced liver injury. There have been cases in which Kampo formulas containing Scutellariae Radix were challenged as the causal drug, and the challenge resulted in repeated liver injury [14, 17]. Generally, however, the challenge test is not recommended, as it is accompanied by risks.…”

Section: Resultsmentioning

confidence: 99%

“…Cases in which so-called “unintentional challenge tests” were performed incidentally have also been reported. In such cases, the patient took (or the physician prescribed) a Kampo formula containing Scutellariae Radix without realizing that it might result in a challenge test [14–16, 18, 19]. Therefore, the involvement of an immunoallergic mechanism in liver injury induced by Kampo medicine, at least by Scutellariae Radix, has been suggested, as liver injury recurs upon readministration for a short period.…”

Section: Resultsmentioning

confidence: 99%

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Adverse Events Associated with Ethical Kampo Formulations: Analysis of the Domestic Adverse-Event Data Reports of the Ministry of Health, Labor, and Welfare in Japan

Shimada

Fujimoto

Nogami

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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Objectives. Traditional Japanese Kampo medicines have been integrated into the Japanese national health-care system. In Japan, the Ministry of Health, Labor, and Welfare’s website discloses adverse drug-event data that have been obtained from medical personnel reports investigated by the Pharmaceutical and Medical Devices Agency. Using these data, we investigated adverse events associated with ethical Kampo formulations. Methods. Reports of adverse events associated with ethical Kampo formulations from the domestic adverse-event data were obtained from July 30, 2003, to March 31, 2018. Adverse events were then categorized, and the relationships between categories of adverse events and crude drugs were analyzed. Results. There were 4,232 reported adverse events associated with ethical Kampo formulations. The numbers of events by category were as follows: events related to liver injury, 1,193; lung injury, 1,177; pseudoaldosteronism, 889; mesenteric phlebosclerosis, 223; drug eruption, 185; and others, 565. Among events related to both liver injury and lung injury, approximately 70% were suspected to be induced by Kampo formulations containing Scutellariae Radix. The pseudoaldosteronism-related events, which are induced by Glycyrrhizae Radix, included several events related to muscle injury, heart failure, and arrhythmia. Events related to mesenteric phlebosclerosis, believed to be induced by long-term use of Kampo formulas containing Gardeniae Fructus, increased remarkably during the study period. Among the events related to drug eruption, approximately 35% were suspected to be induced by Kampo formulations containing Ephedrae Herba. Conclusion. Kampo medicines may cause various adverse events. The present results provide valuable information regarding adverse events associated with Kampo medicines from the viewpoint of patient safety.

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“…Sho‐saiko‐to consists of a mixture of extracts from seven different herbs: Bupleurum root, Pinellia tuber, Scutellaria root, Jujube fruit, Ginseng root, Glycyrrhiza root and Ginger rhizome 10 . Although herbal medicines such as Sho‐saiko‐to are believed to be safe, liver damage induced by these agents has been reported 11 . The major mechanism of such hepatotoxicity may be immunoallergic.…”

Section: Discussionmentioning

confidence: 99%

Changes in titers of antimitochondrial and antinuclear antibodies during the course of primary biliary cirrhosis

Masuda

Omagari

Matsuo

et al. 2001

J of Gastro and Hepatol

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A case of primary biliary cirrhosis (PBC) in whom a complete biochemical (serum bilirubin, transaminases and alkaline phosphatase) remission was noted after combination treatment with ursodeoxycholic acid (UDCA) and corticosteroid is reported. The antimitochondrial antibody (AMA) detected by indirect immunofluorescence was initially positive, and the antinuclear antibody (ANA) was negative, but these two antibodies subsequently fluctuated independently (AMA-positive/ANA-negative, AMA-negative/ANA-negative, AMA-negative/ANA-positive, AMA-positive/ANA-positive, and again AMA-negative/ANA-positive) in spite of a lack of histopathological improvement in the liver after treatment. The clinical presentation in our case suggests that in some cases the diagnosis of PBC or so-called autoimmune cholangitis (AIC) might depend on the 'phase' of the same disease. Our results also suggest that detailed immunoreactive profiles against 2-oxo-acid dehydrogenase complex (2-OADC) enzymes by using immunoblotting, together with a serial histological examination, should provide more precise information for a diagnosis of PBC.

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A case of drug-induced liver damage caused by Sho-saiko-to.

Cited by 5 publications

References 0 publications

Recurrent Drug-induced Liver Injury Caused by the Incidental Readministration of a Kampo Formula Containing Scutellariae Radix

Recurrent Drug-induced Liver Injury Caused by the Incidental Readministration of a Kampo Formula Containing Scutellariae Radix

Adverse Events Associated with Ethical Kampo Formulations: Analysis of the Domestic Adverse-Event Data Reports of the Ministry of Health, Labor, and Welfare in Japan

Changes in titers of antimitochondrial and antinuclear antibodies during the course of primary biliary cirrhosis

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