A Case of Turmeric-Induced Hepatotoxicity with Hyperferritinemia.

Introduction: We present the first published case of turmeric-associated drug-induced liver injury (DILI) accompanied by significant ferritin elevation.

Case presentation: Our patient, a 59-year-old female with DILI caused by long-term ingestion of oral turmeric supplements, presented with painless jaundice on an annual exam. The patient's liver function tests exhibited a hepatocellular pattern and hyperferritinemia (>2,000 ng/dL). Additional testing was negative except for heterozygosity for the H63D allele associated with hemochromatosis. A liver biopsy indicated acute hepatitis without fibrosis or stainable iron.

Conclusion: Upon discontinuation of the supplement, liver enzymes normalized within a month. This case highlights the potential for hepatotoxicity and hyperferritinemia from curcumin toxicity, particularly when combined with additives like black pepper that enhance its bioavailability. Awareness of this phenomenon, particularly in heterozygous carriers of hemochromatosis, is crucial for diagnosis and optimal management.