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Severe hepatitis secondary to green tea intoxication: case report A 29-month-old boy developed severe hepatitis secondary to green tea intoxication. The boy, who had severe acute hepatitis of 2 weeks of evolution, was consulted to the Hepatology Department of a hospital. He was born at term, 37 weeks, twin pregnancy. At 6 months of life, he was diagnosed with cow milk protein allergy, for which he followed a dairy exclusion diet up to one year of age. From that time, he had milk aversion and therefore his mother replaced it with green tea infusions. His brother was not given green tea. He had no recent travel history. His mother had a history of systemic lupus erythematosus and sibling had a history of gastroesophageal reflux and repeated bronchospasms. As background for the current illness, 1 month before the admission, he had developed acute otitis media, and was treated with amoxicillin for 7 days, acute rash and diarrhoea of 5 days, with rotavirus collection on faecal matter. Due to the persistence of fever, 10 days later, he underwent a laboratory test at another care facility, and it showed ALT of 400 IU/L as the only positive piece of information. With this result, he performed an outpatient visit to the Hepatology Department at the center of a hospital (current presentation). At the time of interrogation, his mother reported that green tea was the only drink her child agreed to take and had been given for 5 months before, at the rate of 2 to 3 cups/day, during breakfast and lunch (tea bag containing 0.8g green tea; each green tea cup contributed 80–106mg polyphenols, which would be equivalent to 36–47.7g in 5 months). Thinking about green tea as a hepatotoxic agent, the family was instructed to discontinue the infusion and control the evolution. Twenty four hours following the discontinuation of green tea, a new test reported AST of 2536 IU/L, ALT at 1679 IU/L, with prothrombin time at 70%, INR of 1.2 and factor V of 85%. With such results, the boy’s admission was decided for clinical management and further testing. A color Doppler during abdominal ultrasound reported a liver with a discrete increase in size and signs of periportal oedema, vesicle of thin walls. Hepatitis A antibodies and Hepatitis B surface antibodies (HBsAb) were found to be positive. He had elevated liver enzymes. Four days following the cessation of green tea, a significant reduction was initiated, and it was decided to postpone the completion of the liver biopsy. Having ruled out infectious, autoimmune, metabolic and other hepatotoxic causes, with the sustained amelioration in laboratory tests and since he continued with good physical state, he was discharged from the hospital with a diagnosis of severe hepatitis associated with chronic consumption of green tea (green tea intoxication) [duration of treatment to reaction onset not stated]. Three months following discharge, the laboratory test revealed a normal hepatogram. D’Agostinoa D, et al. Severe hepatitis caused by green tea intoxication in a child. Case report. Archivos Argen