A case of autoimmune hepatitis superimposed by Ukon-induced liver injury

Abstract

A 50 year-old female developed jaundice after taking Ukon(a folk medicine made of Curcuma longa). Her clinical course and laboratory data including DLST fulfilled the criteria to a diagnosis with drug-induced ("Ukon- induced" in this case) hepatitis. But, the abstinence from Ukon did not yield in complete recovery, and her residual hepatitis was then treated with prednisolone with a satisfactory outcome. She developed liver injury again 50 days after withdrawal of prednisolone, however, and at this stage her hepatitis was diagnosed as autoimmune hepatitis based on liver biopsy, positive SMA antibodies, and other findings. These two episodes of her hepatitis suggested the Ukon might have induced or triggered the development of autoimmune hepatitis de novo, or that her preexisting (cryptic) autoimmune hepatitis was affected by the superimposed Ukon-induced liver injury.