Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2022; 10(27): 9921-9928
Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9921
Concurrent severe hepatotoxicity and agranulocytosis induced by Polygonum multiflorum: A case report
You-Lin Shao, Chun-Ming Ma, Jian-Ming Wu, Feng-Cai Guo, Suo-Cai Zhang
You-Lin Shao, Chun-Ming Ma, Jian-Ming Wu, Feng-Cai Guo, Suo-Cai Zhang, Department of Hepatology, Changzhou Third People's Hospital, Changzhou 213001, Jiangsu Province, China
Author contributions: Shao YL analyzed and interpreted the clinical data, and wrote the draft of this manuscript; Zhang SC reviewed the manuscript; Ma CM, Wu JM, and Guo FC collected the patient’s clinical information; all authors read and approved the final manuscript.
Supported by Applied Basic Research Project of Changzhou, No. CJ20190080.
Informed consent statement: The patient consented to all treatments and provided informed written consent prior to this case report.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: You-Lin Shao, MD, Chief Physician, Department of Hepatology, Changzhou Third People's Hospital, No. 300 North Lanling Road, Changzhou 213001, Jiangsu Province, China.
Received: May 17, 2022
Peer-review started: May 17, 2022
First decision: June 16, 2022
Revised: June 24, 2022
Accepted: August 21, 2022
Article in press: August 21, 2022
Published online: September 26, 2022
Core Tip

Core Tip: Polygonum multiflorum is a common traditional Chinese medicine and is commonly used as a dietary supplement. However, severe idiosyncratic hepatotoxicity in certain individuals has been reported. Moreover, if idiosyncratic agranulocytosis occurs simultaneously, it may be fatal. Roussel Uclaf Causality Assessment Method scale and Naranjo algorithm are useful tools for the assessment of drug-induced liver injury and adverse drug reactions, respectively. Early discontinuation can prevent disease progression, facilitating recovery. The combination therapy of glucocorticoids, anti-inflammatory medications, and liver protection is beneficial for idiosyncratic drug reactions.