Female patient, 33 years old, black, with no personal medical history of interest or toxic habits.
He did not undergo any home treatment.
He was admitted to our hospital due to nonspecific abdominal pain located in the right hypochondrium for several days, accompanied by nausea, occasional vomiting, anorexia and since the onset of symptoms shortly before admission to the hospital with asthenia.
The physical examination showed a conscious and oriented patient (without neurological deterioration during the whole hospitalization), weak mucocutaneous jaundice and mild painful hepatomegaly.
In particular, there were no data suggesting chronic liver disease.
Acquired laboratory tests were performed to determine the presence of white blood cell count, coagulation tests and liver profile. At admission, total bilirubin (BT) and direct bilirubin (BD) levels were 8.10 mg/dl and alkaline ALT levels were 27
Laboratory abnormalities reached a maximum level on the sixth day of admission with a TB and BD of 18.88 mg/dl and 15.53 mg/dl respectively and a prothrombin activity of 37% (INR 2.19).
After establishing the diagnosis of acute hepatitis, an etiological study was initiated in which we included infectious serology against hepatitis A virus (HAV), B virus (HBV) and C virus (HCV), cytomegalovirus and herpes simplex virus burn
Viral replication of HBV and HCV was investigated using polymerase chain reaction (PCR) techniques.
We could rule out Wilson's disease, alpha-1-antitrypsin deficiency, hyperthyroidism, hemochromatosis (C282Y and H63D mutations) and autoimmune hepatitis, antinuclear antibodies.
Several abdominal studies were performed and biliary or vascular hepatic alterations were ruled out.
After excluding the known causes of acute hepatitis, we insisted on the anamnesis before the possibility that it was a case of hepatotoxicity by drugs.
It was then when he said that on his recent trip to Ecuador, about two weeks before his admission to the hospital, he had taken, for several days, a herbal preparation commonly called Noni.
The patient was reviewed a few weeks on an outpatient basis in our consultations, verifying the normalization of all the analytical alterations described and the complete disappearance of the symptoms that led to the admission.
