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Vol. 73, No. 2-3, 2006
Issue release date: July 2006
Section title: Case Report
Digestion 2006;73:167–170
(DOI:10.1159/000094524)

Hepatitis Induced by Noni Juice from Morinda citrifolia: A Rare Cause of Hepatotoxicity or the Tip of the Iceberg?

Yüce B. · Gülberg V. · Diebold J. · Gerbes A.L.
aDepartment of Internal Medicine II and bInstitute of Pathology, Ludwig Maximilians University of Munich, Munich, Germany

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Article / Publication Details

First-Page Preview
Abstract of Case Report

Received: 2/7/2006
Accepted: 4/24/2006
Published online: 7/28/2006

Number of Print Pages: 4
Number of Figures: 2
Number of Tables: 1

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: http://www.karger.com/DIG

Abstract

A 24-year-old female patient presented to her community hospital with mild elevations of serum transaminase and bilirubin levels. Because of multiple sclerosis, she was treated with interferon beta-1a for 6 weeks. After exclusion of viral hepatitis due to hepatitis A–E, interferon beta-1a was withdrawn under the suspicion of drug-induced hepatitis. One week later, she was admitted again to her community hospital with severe icterus. The transaminase and bilirubin levels were highly elevated, and a beginning impairment of the liver synthesis was expressed by a reduced prothrombin time. The confinement to our department occurred with a fulminant hepatitis and the suspicion of beginning acute liver failure. There was no evidence for hepatitis due to potentially hepatotoxic viruses, alcoholic hepatitis, Budd-Chiari syndrome, hemochromatosis, and Wilson’s disease. In her serum there were high titers of liver-kidney microsomal type 1 autoantibody; the serum gamma globulin levels were in the normal range. Fine-needle aspiration biopsy of the liver ruled out an autoimmune hepatitis but showed signs of drug-induced toxicity. During the interview, she admitted that for ‘general immune system stimulation’ she had been drinking Noni juice, a Polynesian herbal remedy made from a tropical fruit (Morinda citrifolia), during the past 4 weeks. After cessation of the Noni juice ingestion, her transaminase levels normalized quickly and were in the normal range within 1 month.


  

Author Contacts

Veit Gülberg, MD
Department of Internal Medicine II, Ludwig Maximilians University of Munich
Marchioninistrasse 15
DE–81377 München (Germany)
Tel. +49 89 7095 0, Fax +49 89 7095 5284, E-Mail veit.guelberg@med.uni-muenchen.de

  

Article Information

Published online: July 11, 2006
Number of Print Pages : 4
Number of Figures : 2, Number of Tables : 1, Number of References : 9

  

Publication Details

Digestion (International Journal of Gastroenterology)

Vol. 73, No. 2-3, Year 2006 (Cover Date: July 2006)

Journal Editor: Beglinger, C. (Basel)
ISSN: 0012–2823 (print), 1421–9867 (Online)

For additional information: http://www.karger.com/DIG


Article / Publication Details

First-Page Preview
Abstract of Case Report

Received: 2/7/2006
Accepted: 4/24/2006
Published online: 7/28/2006

Number of Print Pages: 4
Number of Figures: 2
Number of Tables: 1

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: http://www.karger.com/DIG


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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