대한내과학회 홈 로그인 사이트맵관리자에게 전자논문투고The Korean Association of Internal Medicine관련사이트
   
      The Korean Journal of Medicine 2010 ; 78 (4) : p.457~465
Clinical features of 28 acutely toxic hepatitis patients who ingested Dictamnus dasycarpus: A single center clinical experience
(백선 복용 후 발생한 독성 간염 28예의 임상적 특징)
저자 정재훈1, 김석현2, 고광훈2, 정경혜2, 황세웅2, 고평곤2, 박남환2, 남관우2, 김정일2, 문희석2, 이엄석2, 성재규2, 이병석2, 이헌영2, 강대영3
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Background/Aims: The aim of this study was to investigate the clinical features of acutely toxic hepatitis associated with ingesting Dictamnus dasycarpus (D. dasycarpus).
Methods: Between January 2004 and July 2009, 28 patients were enrolled in this study. We reviewed the medical records retrospectively. Acutely toxic hepatitis associated with D. dasycarpus was diagnosed by a Roussel Uclaf Causality Assessment Method Values (RUCAM) score of 6 or above. All patients were tested for viral hepatitis A, B, C, cytomegalovirus, and Epstein-Barr virus. Other tests included anti-nuclear antibody, anti-mitochondrial antibody, and anti-smooth muscle antibody. Abdominal pelvic computed tomography was performed.
Results: The incidence was female predominant (64% vs. 36%). The mean patient age was 53.0±11 years. The symptoms were jaundice (68%), fatigue (57%), nausea (43%), anorexia (43%), and abdominal pain (24%). The mean RUCAM score was 7.0±0.8. The biochemical patterns of hepatotoxicity were hepatocellular (n=23, 82%) and mixed types (n=5, 18%). Radiologic findings were as follows: normal findings (29%), lymphadenopathy (50%), edema of the gall bladder wall (46%), periportal edema (43%), splenomegaly (11%), fatty liver (11%), and ascites (7%). The mean hospitalization period was 21.6±11.6 days. The mean duration of recovery from hepatitis was 56.6±30.4 days, and all patients recovered completely from the toxic hepatitis. One patient who had severe jaundice developed a complication of pure red cell aplasia during the hospitalization period.
Conclusions: The biochemical pattern of liver injury was hepatocellular predominant. Although the initial manifestations and clinical course were variable, all patients completely recovered with supportive care or steroid treatment. Toxic hepatitis was accompanied by pure red cell aplasia in one patient. (Korean J Med 78:457-465, 2010)

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