Ascorbic acid/bulbine natalensis/gelatin/potassium nitrate/RAD 140/silicon dioxide/stearic acid/VK 5211/Gelatin/oryza sa
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Ascorbic acid/bulbine natalensis/gelatin/potassium nitrate/RAD 140/silicon dioxide/stearic acid/VK 5211/Gelatin/oryza sativa/RAD 140
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Liver injury: case report A 52-year-old man developed drug-induced liver injury while receiving treatment with ascorbic acid/bulbine natalensis/gelatin/ potassium nitrate/RAD-140/silicon dioxide/stearic acid/VK 5211 and gelatin/oryza sativa/RAD-140 as dietary supplements. The man presented to the clinic for evaluation of jaundice and an elevated liver enzyme. He presented with symptoms included jaundice, pruritis, diarrhoea and right upper quadrant pain. Around 4 months before his presentation, he initiated using 2 capsules of gelatin/oryza sativa/RAD-140 (1 capsule contains 10mg of RAD-140, the bottle contains 60 capsules* ) [alpha bolic] daily for 4 weeks. After finishing gelatin/oryza sativa/RAD-140, he consumed 2 capsules of ascorbic acid/bulbine natalensis/gelatin/ potassium nitrate/RAD-140/silicon dioxide/stearic acid/VK 5211 (1 capsule contains 7.5mg of RAD-140 and 5mg of VK 5211 [LGD-4033], the bottle contains 60 capsules) [alpha elite] daily for 3 weeks for muscle building. Total period of the supplement consumption (oral route) was 7 weeks. Following that he developed jaundice, pruritis, greasy diarrhoea and right upper quadrant pain. Physical examination revealed scleral icterus and jaundice. Laboratory findings showed AST 36 U/L, ALT 46 U/L, ALP 529 U/L, total bilirubin 34.5 mg/dL, INR 1.0, GGT 47 U/L, total protein 5.5 g/dL, globulin 1.7 g/dL, and albumin 3.8 g/dL. Ultrasound-guided biopsy revealed prominent ductular reaction, mild lobular inflammation and diffuse centrilobular canalicular cholestasis, with rare non-necrotizing epithelioid granuloma and mild portal and periportal fibrosis suggestive of drug-induced liver injury. The liver biopsy also revealed mild to moderate haemosiderosis. He was diagnosed with cholestasis and drug-induced liver injury. The man discontinued consumption of supplements and alcohol. Approximately 3 months after discontinuation of supplements total bilirubin, ALP, and aminotransferase levels markedly improved. * The author states bottle containing 60 tablets; however the marketed formulation was available in capsule form. Barbara M, et al. Drug-induced liver injury associated with alpha bolic (rad-140) and alpha elite (rad-140 and lgd-4033). ACG Case Reports Journal 7: e00409, No. 6, Jan 803516378 2020. Available from: URL: http://doi.org/10.14309/crj.0000000000000409
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Reactions 21 Nov 2020 No. 1831
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