Gut Liver.  2009 Mar;3(1):52-56.

Reactivation of Pulmonary Tuberculosis in a Patient with Polygonum multiflorum Thunb-Induced Hepatitis

Affiliations
  • 1Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea. lyreju@naver.com

Abstract

Several cases of Polygonum multiflorum Thunb-induced hepatitis have been reported worldwide. Anthraquinone is an active ingredient of P. multiflorum Thunb. that has been thought to play a role in its hepatotoxicity. Here we report the case of a 34-year-old Korean man who had P. multiflorum Thunb-induced hepatitis and reactivation of pulmonary tuberculosis caused by bone marrow suppression, which developed simultaneously. He was admitted to our hospital with recently developed fatigue and aggravated jaundice. He was a previously healthy man except for the sequelae of pulmonary tuberculosis seen on chest X-ray. He had a 30-day history of ingesting the root of P. multiflorum as a form of liquor and tea. The patient was diagnosed with P. multiflorum Thunb-induced hepatitis after excluding all other potential causes of acute hepatitis. Liver function gradually improved following the total cessation of the consumption of the material. However, he suffered from spiking fever with progressive pancytopenia during the hospital stay. A bone marrow biopsy showed markedly hypocellular marrow, suggesting transient bone marrow suppression, which was probably caused by extrinsic factors such as drugs, toxins, and viral infection. Although he began to complain of a dry cough, repeated sputum investigations revealed positive acid-fast bacillus staining. The fever subsided and pancytopenia improved after treatment for pulmonary tuberculosis. These observations suggest that P. multiflorum Thunb induces both bone marrow suppression and hepatotoxicity.

Keyword

Polygonum multiflorum Thunb; Hepatotoxicity; Bone marrow suppression; Pulmonary tuberculosis

MeSH Terms

Adult
Bacillus
Biopsy
Bone Marrow
Cough
Fatigue
Fever
Hepatitis
Humans
Jaundice
Length of Stay
Liver
Pancytopenia
Polygonum
Sputum
Tea
Thorax
Tuberculosis, Pulmonary
Tea
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