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Concurrent severe hepatotoxicity and agranulocytosis induced by Polygonum multiflorum: A case report

You-Lin Shao1, Chun-Ming Ma2, Jian-Ming Wu2

  • 1Department of Hepatology, Changzhou Third People's Hospital, Changzhou 213001, Jiangsu Province, China. syl84289@aliyun.com.

World Journal of Clinical Cases
|October 3, 2022
PubMed
Abstract

Insights

Polygonum multiflorum (PM) can cause rare but severe adverse drug reactions, including concurrent hepatotoxicity and agranulocytosis. This case highlights the critical need for vigilance regarding these dual toxicities from PM ingestion.

Area of Science:

  • Hepatology
  • Hematology
  • Pharmacovigilance

Background:

  • Polygonum multiflorum (PM) is recognized for inducing various forms of drug-induced liver injury.
  • Neutropenia is an uncommon adverse effect associated with PM use.

Observation:

  • A 65-year-old woman presented with severe hepatotoxicity and agranulocytosis 17 days post-ingestion of PM.
  • Diagnostic assessments using the Roussel Uclaf Causality Assessment Method and Naranjo algorithm indicated a highly probable link between PM and the observed conditions.

Findings:

  • The patient received treatment including granulocyte colony-stimulating factor, steroids, compound glycyrrhizin, and polyene phosphatidylcholine.
  • Significant improvement in liver function tests, leukocytes, and neutrophil counts was observed after 15 days of therapy.

Implications:

  • Concurrent severe hepatotoxicity and agranulocytosis represent rare but critical adverse drug reactions associated with PM.
  • Healthcare providers should maintain a high index of suspicion for these dual toxicities when patients report PM use.
Keywords:
AgranulocytosisCase reportHepatotoxicityPolygonum multiflorum

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