Good for the lung but bad for the liver? Garlic-induced hepatotoxicity following liver transplantation

S A Shaikh; S Tischer; E K Choi; R J Fontana

doi:10.1111/jcpt.12558

Good for the lung but bad for the liver? Garlic-induced hepatotoxicity following liver transplantation

J Clin Pharm Ther. 2017 Oct;42(5):646-648. doi: 10.1111/jcpt.12558. Epub 2017 May 25.

Authors

S A Shaikh¹, S Tischer¹, E K Choi², R J Fontana³

Affiliations

¹ Department of Pharmacy Services and Clinical Sciences, Michigan Medicine, Ann Arbor, MI, USA.
² Department of Pathology, Michigan Medicine, Ann Arbor, MI, USA.
³ Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA.

PMID: 28543822
DOI: 10.1111/jcpt.12558

Abstract

What is known and objective: Limited data exist surrounding the metabolism and safety of garlic supplements.

Case description: A patient with a history of hepatopulmonary syndrome (HPS) and orthotopic liver transplantation was admitted to our surgery transplant service with severe hypoxaemia. The patient was started on high-dose Garlicin Cardio^® (Allium sativum) for HPS and soon after had elevated liver function tests. Garlicin Cardio^® was discontinued and liver enzymes normalized. A liver biopsy revealed mild periportal cholestatic reaction suggesting potential drug-induced aetiology.

What is new and conclusion: This is the first description of liver injury secondary to garlic supplementation. Therefore, this garlic supplement should be listed as a potential cause of acute drug-induced liver injury.

Keywords: drug interaction; garlicin; hepatopulmonary; liver.

Publication types

Case Reports

MeSH terms

Adult
Chemical and Drug Induced Liver Injury / etiology*
Dietary Supplements / adverse effects*
Garlic / adverse effects*
Garlic / chemistry
Hepatopulmonary Syndrome / surgery
Humans
Liver Function Tests
Liver Transplantation*
Male