A Case of Acute Pancreatitis and Acute Hepatitis Caused by Ingestion of Ceramium kondoi

Da-bin Kim; Yoo-Kyung Cho; Hyun Joo Song; Byung-Cheol Song

doi:10.4166/kjg.2013.62.5.306

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Kim, Cho, Song, and Song: A Case of Acute Pancreatitis and Acute Hepatitis Caused by Ingestion of Ceramium kondoi

Case Report

Korean J Gastroenterol 2013;62(5):306-309.

Published online: 4 October 2013

DOI: https://doi.org/10.4166/kjg.2013.62.5.306

A Case of Acute Pancreatitis and Acute Hepatitis Caused by Ingestion of Ceramium kondoi

Da-bin Kim¹, Yoo-Kyung Cho, Hyun Joo Song, Byung-Cheol Song

Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea

¹Department of Medicine, Jeju National University School of Medicine, Jeju, Korea

Correspondence to: Yoo-Kyung Cho, Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju 690-767, Korea. Tel: +82-64-717-2069, Fax: +82-64-717-1131, E-mail: choyk1120@hanmail.net

Received 7 March 2013 Revised 23 April 2013 Accepted 23 April 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In Korea, the use of herbal remedies is a common cause of drug-induced liver injury. However, the occurrence of both acute pancreatitis and acute hepatitis after taking herbal remedies has rarely been reported. Herein, we report a case of concurrent acute pancreatitis and acute hepatitis associated with Ceramium kondoi ingestion. A 58-year-old woman was diagnosed with advanced gastric cancer 7 months ago. Total gastrectomy and adjuvant chemotherapy was performed without complications. The patient had been well until recently, when she presented with severe abdominal pain after ingestion of Ceramium kondoi for 4 weeks. The laboratory findings demonstrated elevated liver enzymes and lipase, and abdominal computed tomography revealed pancreas swelling with fat infiltration. The diagnosis was made based on the diagnostic criteria for drug induced pancreatitis and the Russel Uclaf Causality Assessment Method scale for drug-induced liver injury. After cessation of Ceramium kondoi, she showed clinical and biochemical improvement.

Keywords: Drug-induced liver injury, Pancreatitis, Herbal remedies

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Fig. 1.

Abdominal computed tomography. (A) Enlarged uncinate process with irregular low density from edema was noted (arrow). (B) Peripancreatic fat linear strands could also be seen (arrow). (C) Gallbladder distension (arrow) and focal wall thickening (arrow head) were demonstrated on coronal image.

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