Concurrent severe hepatotoxicity and agranulocytosis induced by Polygonum multiflorum: A case report.

BACKGROUND: Various types of drug-induced liver injury are induced by Polygonum multiflorum (PM); however, it rarely causes neutropenia. Herein, we report the case of a 65-year-old woman with concurrent severe hepatotoxicity and agranulocytosis induced by PM. CASE SUMMARY: A 65-year-old woman reported with severe hepatotoxicity and agranulocytosis 17 d after ingestion of PM. The results of the Roussel Uclaf Causality Assessment Method demonstrated a highly probable relationship between hepatotoxicity and PM, with a total score of 10. The Naranjo algorithm results indicated that agranulocytosis had a probable relationship with PM, with an overall score of 6. Granulocyte colony-stimulating factor (for once), a steroid, compound glycyrrhizin, and polyene phosphatidylcholine therapy were initiated. After 15 d of treatment, there was a gradual improvement in liver biochemistry, leukocytes, and neutrophils levels. CONCLUSION: Concurrent hepatotoxicity and agranulocytosis are rare and critical adverse drug reactions of PM, which should be highly valued.

[Prognosis comparison in middle and later stage severe hepatitis B patients treat with plasma exchange or unified medicine therapy].

OBJECTIVE: To observe the influence on the prognosis of the patients with severe hepatitis B in middle and later stage treated with plasma exchange or unified medicine therapy, and search the therapy methods on the middle and later stage severe hepatitis B. METHODS: To observe the liver function, complications and prognosis of the patients treated with plasma exchange on the basis of unified medicine therapy. To compare with that of the corresponding period patients with unified medicine therapy and analysis the clinical data with statistics methods. RESULTS: 36 cases of the plasma exchange group, 18 cases survived and 18 cases died. 32 cases of the unified medicine therapy group, 13 cases survived and 19 cases died. The survival rates between the two groups patients does not appear statistics difference;liver function index (ALT, AST, SB, ALB, TC, ChE) and PT also appear the same results in statistics. CONCLUSIONS: Compare with unified medicine therapy, plasma exchange on the basis of the unified medicine therapy does not appear to improve survival rate of the patients with the middle and later stage severe hepatitis B. The prognosis of these patients determined by the liver failure extent itself.