Conjugated Linoleic Acid-Induced Toxic Hepatitis: First Case Report

Abstract

A 46-year-old female patient was referred to our department with presenting symptoms of asthenia, jaundice, and pruritus. There was no medical history or clinical evidence of viral hepatitis, autoimmune hepatitis, hemochromatosis, or Wilson's disease. The patient revealed that 14 days prior to admission she had begun self-medicating with conjugated linoleic acid (CLA) to reduce body fat, leading to the suspicion of CLA hepatotoxicity, which was subsequently confirmed by a liver biopsy. After the patient ceased to ingest CLA, liver enzymes levels normalized. To the best of our knowledge, this is the first report of hepatotoxicity due to CLA ingestion.

Polypharmacy, multiple natural health products and hepatotoxicity

“…14 In contrast, active surveillance involves protocol-driven screening of risk groups, which in turn allows for more accurate estimates of incidence and the generation of reports that are more consistent and of a higher quality. 4 This case demonstrates an example of active surveillance. This type of process can be used to assess potential adverse events caused by medications or natural health products.…”

“…Several of the natural health products have been associated with hepatotoxicity; however, much of the information about these associations is from studies done on animals or in vitro, and precise dosage information is limited. [4][5][6][7][8][9][10][11][12]15 Both venlafaxine and varenicline have been reported to cause hepatotoxicity in patients, especially in those with underlying liver conditions. [1][2][3] Tables 1 and 2 provide summaries of the patient's medications and any published evidence of hepatotoxicity associated with their use.…”

“…Over the past three months, she had been taking six prescription medications (Table 1) 1-3 and seven natural health products (Table 2). [4][5][6][7][8][9][10][11][12] Her bilirubin level had been elevated (281 [normal 3.4-22] µmol/L), as had her liver enzyme levels (alanine transaminase 755 [normal ] U/L and alkaline phosphatase 273 [normal 42-98] U/L). An ultrasound of her abdomen had been consistent with cirrhosis, and the presumptive diagnosis had been cirrhotic liver disease.…”

A Review of Cases of Development of Acute Hepatic Insufficiency Due to the Intake of Biologically Active Additives

“…Было также показано, что она стимулирует иммун-ные реакции, улучшает чувствительность к инсулину и изменяет метаболизм липидов. Несмотря на преимущества, приписываемые КЛК, сообщалось о трех случаях поврежде-ния печени, вызванного приемом этой БАД [46]. Все пациенты были женщинами, с гепа-тоцеллюлярным типом повреждения печени после приема КЛК для ускорения потери веса.…”

“…Наиболее тяжелым пациентом была 63-лет-няя женщина, которая принимала только таблетки КЛК в течение одного месяца и по-ступила в больницу с высокими уровнями АЛТ (2300 ммоль/л), АСТ (2300 ммоль/л), у пациентки развилась энцефалопатия и по-требовалась трансплантация печени [47]. У двух других пациенток был повышен уро-вень трансаминаз (АЛТ 2101 ммоль/л, АСТ 1663 ммоль/л и АЛТ 1078 ммоль/л, АСТ 1519 ммоль/л соответственно), кроме того, у одной из них развилась желтуха [46,48]. Оба случая имели полное разрешение после прекращения приема КЛК.…”