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Case Reports
. 2022 Sep 26;10(27):9921-9928.
doi: 10.12998/wjcc.v10.i27.9921.

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

You-Lin Shao  1 , Chun-Ming Ma  2 , Jian-Ming Wu  2 , Feng-Cai Guo  2 , Suo-Cai Zhang  2
Affiliations
Case Reports

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

You-Lin Shao et al. World J Clin Cases. .

Abstract

Background: Various types of drug-induced liver injury are induced by Polygonum multiflorum (PM); however, it rarely causes neutropenia. Herein, we report the case of a 65-year-old woman with concurrent severe hepatotoxicity and agranulocytosis induced by PM.

Case summary: A 65-year-old woman reported with severe hepatotoxicity and agranulocytosis 17 d after ingestion of PM. The results of the Roussel Uclaf Causality Assessment Method demonstrated a highly probable relationship between hepatotoxicity and PM, with a total score of 10. The Naranjo algorithm results indicated that agranulocytosis had a probable relationship with PM, with an overall score of 6. Granulocyte colony-stimulating factor (for once), a steroid, compound glycyrrhizin, and polyene phosphatidylcholine therapy were initiated. After 15 d of treatment, there was a gradual improvement in liver biochemistry, leukocytes, and neutrophils levels.

Conclusion: Concurrent hepatotoxicity and agranulocytosis are rare and critical adverse drug reactions of PM, which should be highly valued.

Keywords: Agranulocytosis; Case report; Hepatotoxicity; Polygonum multiflorum.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Microscopic view of bone marrow aspirate showing severe agranulocytosis. A: A neutrophilic myelocyte; B: A neutrophilic myelocyte and a promyelocyte.
Figure 2
Figure 2
Clinical course of the patient. A: Changes in levels of alanine aminotransferase, aspartate aminotransferase, and total bilirubin; B: Changes in the count of leukocytes, neutrophils, and lymphocytes. TBIL: Total bilirubin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase.
See this image and copyright information in PMC

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