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

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.

• Authors: Johann von Felden, Matteo Montani, Kerstin Kessebohm, Felix Stickel
• Journal: International journal of clinical pharmacology and therapeutics (Int J Clin Pharmacol Ther) Vol. 51 Issue 3 Pg. 219-23 (Mar 2013) ISSN: 0946-1965 [Print] Germany
• PMID: 23391366 (Publication Type: Case Reports, Journal Article)

Chemical References

• Chondroitin Sulfates
• Glucosamine

Topics

• Acute Disease
• Aged
• Chemical and Drug Induced Liver Injury (etiology)
• Chondroitin Sulfates (adverse effects)
• Diagnosis, Differential
• Dietary Supplements (adverse effects)
• Glucosamine (adverse effects)
• Hepatitis, Autoimmune (etiology)
• Humans
• Male