Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jun 21, 2009; 15(23): 2927-2929
Published online Jun 21, 2009. doi: 10.3748/wjg.15.2927
Severe acute cholestatic hepatitis of unknown etiology successfully treated with the Chinese herbal medicine Inchinko-to (TJ-135)
Susumu Ohwada, Isao Kobayashi, Nobuo Harasawa, Kyoichiro Tsuda, Yosikatsu Inui
Susumu Ohwada, Isao Kobayashi, Nobuo Harasawa, Kyoichiro Tsuda, Kanetsu Chuo Hospital, Kitaharacho 71, Takasaki, Gunma, 370-3513, Japan
Yosikatsu Inui, Inui Clinic of Internal Medicine, Shimokobanamachi Takasaki, Gunma, 370-0076, Japan
Author contributions: Ohwada S organized and wrote the manuscript; Kobayashi I, Harasawa N, Tsuda K, Inui Y provided patient’s data, contributed to manuscript writing, and approved the final manuscript.
Correspondence to: Susumu Ohwada, Kanetsu Chuo Hospital, Kitaharacho 71, Takasaki, 370-3513, Gunma, Japan. gogoohwada@yahoo.co.jp
Telephone: +81-27-3435115
Fax: +81-27-3432260
Received: November 11, 2008
Revised: March 21, 2009
Accepted: March 28, 2009
Published online: June 21, 2009
Abstract

Severe acute hepatitis of unknown etiology is difficult to treat and often progresses to subacute fulminant hepatitis or late-onset hepatic failure. A 45-year-old well-nourished, healthy man had progressive fatigue and his liver function tests showed severe liver dysfunction. The etiology of sever acute cholestatic hepatitis was unknown. The liver function tests normalized gradually, which excluded high persistent total bilirubin after starting on predonine. A liver biopsy showed chronic active hepatitis with mild fibrosis (A2, F1). Oral Inchinko-to, a Chinese herbal medicine, at 7.5 g daily was prescribed. The treatment was effective with no adverse effects. We present a successfully treated case and discuss hepatoprotective and choleretic effects of Inchinko-to.

Keywords: Acute cholestatic hepatitis; Etiology; Inchinko-to; Herbal medicine