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also seen. QT time was 533 ms 3a. QT prolongation which was seen on admission
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5῏ Adachi M, Saito H, Kobayashi H, Horie Y,
ῌ Kato S, Yoshioka M, Ishii H. Hepatic Injury
῍ in 12Patients Taking the Herbal Weight Loss
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Medicine. 2003; 139ῌ6῍: 488ΐ492.
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6῏ Kawata K, Takehira Y, Kobayashi Y, Kita-
QT /5(῍ Torsade de point 6
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Fenfluramine ;<4=>?῍ @A!
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injury caused by Sennomotokounou, a Chinese
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J?;KLMNAO6PQ
2003; 42ῌ12῍: 1188ΐ92.
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15῎ von Moltke LL, Greenblatt DJ, Ciraulo DA,
78
ῌῌ῕῍῎῏῕ῒ῔ῑΐῐ
495
Abstract
A Case of Drug induced Liver Injury Caused by
“Super Slender”, a Chinese Dietary Supplement
for Weight Loss
Hideaki Takahashi1, Hiroshi Yotsuyanagi1, Mayu Orita1, Yoshihiko Nagase1,
Yuka Suzuki1, Yoshiki Katakura1, Noriaki Okuse1, Yutaro Kobayashi1,
Junki Koike2, Yasuhito Takahashi1, Takeshi Hayashi1, Mchihiro Suzuki1,
Shiro Maeyama2, Toshiyuki Uchikoshi2, and Fumio Itoh1
The patient was a 48-year-old woman who had visited the Division of Metabolism and Endocrinology
in our hospital regularly since she was 46-years-old for the treatment of diabetes, hypertension, hyperlipidemia, fatty liver, and obesity. She had been taking the dietary supplement “Super Slender 45” from July 10,
2002 to August 12, 2002 in an e#ort to lose weight. She was admitted to our hospital for the treatment of liver
injury ῌAST, 663 IU῎L; ALT, 1117 IU῎L; g-GTP, 569 IU῎L῍ that was noted during the course of a regular
check-up. Electrocardiography on admission revealed QT interval prolongation. Viral hepatitis, autoimmune hepatitis, alcoholic liver disease, and metabolic liver disease were excluded, and drug-induced liver
injury was considered the most probable diagnosis. Since liver function did not improve even after
terminating administration of the dietary supplement, 50 mg῎day of predonisolone were given just after liver
biopsy. Histological findings from the liver biopsy specimen were compatible with drug-induced liver injury.
Liver function improved immediately, and the patient was discharged after predonisolone dose was tapered
to 5 mg῎day. QT interval prolongation, which gradually normalized without treatment, was presumably
caused by the dietary supplement. Although lymphocyte stimulation testing for the dietary supplement
yielded negative results, liver dysfunction was diagnosed as drug-induced liver injury due to Super Slender
45 based on clinical course and liver biopsy findings.
1 Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University
2 Department of Pathology, St. Marianna University
79