A case report of liver failure caused by Tetrastigma hemsleyanum Diels et Gilg: A rare case report and literature review.

Abstract

Rationale: Tetrastigma hemsleyanum Diels et Gilg is a traditional Chinese medicinal plant recognized for its therapeutic properties, which include heat-clearing, toxicity-eliminating, anti-inflammatory, pain-relieving, blood circulation-promoting, blood stasis-resolving, wind-dispersing, and phlegm-resolving actions. It is predominantly used in clinical settings to manage inflammatory disorders, such as febrile convulsions, hepatitis, snakebites, and cellulitis. To date, no documented cases of liver failure attributable to T hemsleyanum Diels et Gilg have been reported.

Patient concerns: A 50-year-old female patient presented with symptoms of xanthochromia, tea-colored urine, fatigue, and anorexia following a three-day course of T hemsleyanum Diels et Gilg. Liver function tests revealed elevated alanine aminotransferase (1386 U/L) and AST (405 U/L) levels.

Diagnoses: Liver failure induced by T hemsleyanum Diels et Gilg was diagnosed.

Interventions: The patient received treatment that included discontinuation of hepatotoxic drugs, administration of N-acetylcysteine for liver protection, nutritional support, and correction of acid-base and electrolyte imbalances.

Outcomes: After 11 days of liver-protective and nutritional therapy, significant improvements in the patient's condition were noted. The symptoms of xanthochromia and tea-colored urine subsided, and liver function markers decreased markedly, returning to near-normal levels. No further complaints of discomfort were reported, and the patient was discharged with prescribed medications for follow-up.

Lesson: The possibility of liver failure following the use of T hemsleyanum Diels et Gilg should be considered. When patients present with symptoms such as fat intolerance, xanthochromia, poor appetite, nausea, and dark urine after consuming this herb, liver function tests should be promptly conducted to exclude the possibility of drug-induced liver injury. T hemsleyanum Diels et Gilg has the potential to induce liver failure. Liver-protective measures, including nutritional support, proved to be effective in managing the condition.