@article{10.37349/emed.2022.00084,
abstract = {A case of combined acute and chronic liver injury related to consumption of multi-ingredient nutritional oral supplements containing Aloe Vera gel and vitamin A among other vitamins, minerals and dietary elements such as fish and calamari oil in a 59-year-old female with unexplained hypertransaminasemia is reported. A unique complex liver injury was diagnosed on liver biopsy combining histological features of protracted acute hepatitis, mild manifestation of hypervitaminosis A and lipogranulomatous reaction attributed to Aloe Vera, vitamin A and lipids, respectively. Normalization of liver tests was achieved after discontinuation of all nutritional supplements. Updated Roussel Uclaf Causality Assessment Method (RUCAM) score (+8, probable) further supported herb-induced liver injury. The present case highlights the increasing incidence of complex histological liver injury linked to the constantly growing consumption of multi-ingredient dietary supplements and alternative medications.},
author = {Delladetsima, Katerina and Manesis, Εmanuel and Tiniakos, Dina and Sakellariou, Stratigoula},
doi = {10.37349/emed.2022.00084},
journal = {Exploration of Medicine},
pages = {181--187},
title = {{Complex liver injury induced by combined Aloe Vera and vitamin A oral supplements, as assessed by histology and the updated RUCAM}},
url = {https://www.explorationpub.com/Journals/em/Article/100184},
volume = {3},
year = {2022},
number = {2}
}