case_images: PMC11259472_01
case_images: Graphic distribution of liver functions tests. Trend in liver function tests pre-hospitalization and during the patient hospital course. Initial elevation of liver enzymes (black arrow). Improvement of liver enzymes upon temporary discontinuation of turmeric use (green arrow).
case_images: jchim-14-03-055f1.jpg
case_images: PMC11259472_01_jchim-14-03-055f1.jpg
case_images: f1-jchim-14-03-055
case_images: Turmeric was discontinued, and one month later liver enzymes improved (ALT 77U/L, AST 81U/L) though ALP remained persistently elevated (ALP 313U/L) (Fig. 1).
case_images: Histopathology (A) Hematoxylin and eosin staining (40x magnification) demonstrated abundant inflammatory cells and necrosis in association with the central vein (arrowhead). (B) Trichrome staining (40x magnification) demonstrated evidence of bridging fibrosis (arrow).
case_images: jchim-14-03-055f2.jpg
case_images: PMC11259472_01_jchim-14-03-055f2.jpg
case_images: f2-jchim-14-03-055
case_images: Unfortunately, by the 5th day of hospital admission, laboratory diagnostics failed to demonstrate evidence of improvement (Total bilirubin 23.3 mg/dL, ALT 644U/L, AST 841U/L, ALP 286U/L, INR 2.0) and a liver biopsy was performed; histology demonstrated a cirrhotic liver with a mixed inflammatory infiltrate, bile ductular reaction, and hepatocellular necrosis (Fig. 2).