A severe drug induced hepatitis caused by a dietary supplement "Nin-niku Ran-oh" made from garlic and egg yolk

Abstract

Dietary supplements are easily available and increasingly used, and adverse hepatic reactions have been reported following their intake.
A 60 years old woman who took some dietary supplements developed appetite loss, general fatigue, jaundice and subcutaneous hemorrhage together with a > 40-fold increase of transaminase levels and prothrombin time elongation. There were no evidence of viral hepatitis, autoimmune, metabolic or alcohol-related liver disorders. Drug-induced lymphocyte stimulation test was positive to the dietary supplement "Nin-niku Ran-oh", which is made from garlic and egg yolk. DDW-J 2004 drug-induced liver injury score was 10 and diagnosed as highly probable. Seven weeks after discontinuation of the supplements, the liver functions recovered to normal.