[A clinical analysis of 22 patients with drug-induced liver injury caused by traditional Chinese medicine Periploca forrestii Schltr].

Objective: To investigate the clinical features, diagnosis, treatment, and prognosis of patients with liver injury caused by Periploca forrestii Schltr. Methods: A retrospective analysis was performed for the general data, clinical manifestations, and laboratory examinations of 22 patients who were diagnosed with liver injury caused by Periploca forrestii Schltr. from November 2014 to December 2015, and their clinical type was determined according to the classification criteria of drug-induced liver injury recommended by the Council for International Organizations of Medical Sciences. Results: There were 12 female and 10 male patients. The mean medication time ranged from 1 week to 2 months, and as for biochemical markers, there were mainly abnormalities in alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TBil), alkaline phosphatase(ALP), and gamma-glutamyl transpeptidase(GGT). ALT and AST increased in all the patients, with mean levels of 676.68±481.11 U/L and 527.36±361.14 U/L, respectively; TBil increased to a mean level of 170.26±147.30 μmol/L in 19 patients; ALP increased to a mean level of 135.61±59.26 U/L in 13 patients; GGT increased to a mean level of 195.65±138.48 U/L in 20 patients. As for clinical typing, 18 patients had liver cell injury, none had cholestasis, 3 had a mixed type, and 1 had an unclassified type. One patient died and all the other patients fully recovered. Conclusion: Periploca forrestii Schltr. had complex constituents, and liver injury caused by this drug is mainly liver cell injury. The pathogenesis of liver injury caused by Periploca forrestii Schltr. is presumed to be related to patients' idiosyncratic reaction to its constituents.