A 59-year-old woman with no relevant past medical history presented in September 2010 a 15-day history of general malaise with subsequent onset of jaundice in woman, coluria and reception during a vacation period.
As the only epidemiological history of interest, he had taken Inneov capillary mass® for one month before the onset of symptoms.
Physical examination revealed no relevant findings except cutaneous-mucosal jaundice.
Laboratory results are summarized in Table I. Immunological markers and viral serology were negative.
Abdominal ultrasound showed hepatic steatosis with no other abnormalities.
multiple eosinophils, lack of analytical improvement and absence of known etiology it was decided to perform a liver biopsy whose histological examination revealed the presence of portal widening with intense mixed inflammatory infiltrate (lymphocytes, polymorphonuclear and diffuse eosinophil necrosis)
Although the findings were compatible with toxic hepatitis, given the torpid clinical evolution, it was decided to start empirical treatment with prednisone at a dose of 40 mg daily, with significant improvement in liver tests on the fifth day of starting.
The descending steroid treatment was maintained for 6 months, with normalization of liver tests at that time.
In the subsequent follow-up they remained normal for 14 months.
When using the CIOMS/RUCAM scale, causality was probable in this case.
