Published online Nov 8, 2017. doi: 10.4254/wjh.v9.i31.1205
Peer-review started: May 4, 2017
First decision: June 15, 2017
Revised: June 28, 2017
Accepted: August 3, 2017
Article in press: August 3, 2017
Published online: November 8, 2017
Drug induced liver injury is responsible for 50% of acute liver failure in developed countries. Ayurvedic and homeopathic medicine have been linked to liver injury. This case describes the first documented case of Punarnava mandur and Kanchnar guggulu causing drug induced liver injury. Drug induced liver injury may be difficult to diagnosis, but use of multi-modalities tools including the ACG algorithms, causative assessment scales, histological findings, and imaging, is recommended. Advanced imaging, such as magnetic resonance cholangiopancreatography, may possibly have a greater role than previously reported in literature.
Core tip: Drug induced liver injury is difficult to diagnose. Certain ayurvedic medications are commonly used without full knowledge of their side effects. This article not only represents the first documented case report of drug induced liver injury secondary to Punarnava mandur and Kanchnar guggulu, but it also demonstrates the possible role for advanced imaging modalities.