Hepatotoxicity associated with Garcinia cambogia: A case report

Abstract

BACKGROUND

Herbal supplements (HS) for weight loss are perceived to be “safe” and “natural”, as advertised in ads, however, hepatotoxicity can be associated with consumption of some HS. Use of HS may be missed, as the patient may not report these unless specifically asked about these products, since they are often not thought of as medications with potential side effects or interaction potential.

CASE SUMMARY

We reported a case of a 21-year-old female with morbid obesity who presented with abdominal pain for 1 wk associated with nausea, vomiting, anorexia and myalgias. She denied smoking tobacco, drinking alcohol, usage of illicit drugs, hormonal contraceptives, or energy drinks. There was no significant past medical or family illnesses. Her laboratory workup revealed acute liver failure. The workup for possible etiologies of acute liver failure was unremarkable. She was using a weight loss herbal supplement “Garcinia cambogia” for 4 wks. This case demonstrates the association of acute liver failure with Garcinia cambogia.

CONCLUSION

Medical reconciliation of HS should be performed in patients with suspected acute liver failure and early discontinuation of HS can prevent further progression of drug induced hepatoxicity.

Keywords: Hepatotoxicity; Drug induced liver injury; Acute liver failure; Herbal supplements; Garcinia cambogia; Obesity; Case report

Core tip: Drug induced liver injury is a diagnosis of exclusion of possible etiologies of liver failure. Medical reconciliation of herbal supplements is important in these patients. The Council of International Organizations of Medical Sciences and Roussel Uclaf Causality Assessment Method “CIOMS/RUCAM” scale is a useful tool for the assessment of drug induced liver injury. A high index of suspicion is required for identification of patients with drug induced liver failure. Early discontinuation of offending agent may prevent progression of disease and results in rapid recovery.