Hepatotoxicity Associated With the Dietary Supplement N.O.-XPLODE
Authors: Donald J. Martin, Brett J. Partridge, William Shields
Journal: Annals of Internal Medicine (2013)

Letters1 October 2013Hepatotoxicity Associated With the Dietary Supplement N.O.-XPLODEDonald J. Martin, MD, Brett J. Partridge, MD, and William Shields, DODonald J. Martin, MDFrom Landstuhl Regional Medical Center, Landstuhl/Kirchberg, Germany; and Naval Medical Center, San Diego, California.Search for more papers by this author, Brett J. Partridge, MDFrom Landstuhl Regional Medical Center, Landstuhl/Kirchberg, Germany; and Naval Medical Center, San Diego, California.Search for more papers by this author, and William Shields, DOFrom Landstuhl Regional Medical Center, Landstuhl/Kirchberg, Germany; and Naval Medical Center, San Diego, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-7-201310010-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: We noted that many patients have been medically evacuated from Iraq and Afghanistan for probable drug-induced liver injury (1–3) and conducted a retrospective review of their medical records to learn more about their illnesses. Because civilian and military personnel use large amounts of dietary supplements (4), we included information about these supplements in our review.Objective: To describe the clinical characteristics of 12 patients with drug-induced liver injury associated with a specific dietary supplement.Methods and Findings: We identified 798 patients with hepatitis who required medical evacuation from U.S. military facilities in Iraq and Afghanistan between 1 January 2006 ...References1. Abboud G and Kaplowitz N. Drug-induced liver injury. Drug Saf. 2007;30:277-94. [PMID: 17408305] CrossrefMedlineGoogle Scholar2. Ostapowicz G, Fontana RJ, Schiødt FV, Larson A, Davern TJ, Han SH, et al. U. S. Acute Liver Failure Study Group. Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States. Ann Intern Med. 2002;137:947-54 LinkGoogle Scholar3. Uetrecht J. Idiosyncratic drug reactions: current understanding. Annu Rev Pharmacol Toxicol. 2007;47:513-39. [PMID: 16879083] CrossrefMedlineGoogle Scholar4. Lieberman HR, Stavinoha TB, McGraw SM, White A, Hadden LS, and Marriott BP. Use of dietary supplements among active-duty US Army soldiers. Am J Clin Nutr. 2010;92:985-95. [PMID: 20668050] CrossrefMedlineGoogle Scholar5. Chalasani N, Fontana RJ, Bonkovsky HL, Watkins PB, Davern T, Serrano J, et al. Drug Induced Liver Injury Network (DILIN). Causes, clinical features, and outcomes from a prospective study of drug-induced liver injury in the United States. Gastroenterology. 2008;135:1924-34, 1934.e1-4. [PMID: 18955056] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Donald J. Martin, MD; Brett J. Partridge, MD; William Shields, DOAffiliations: From Landstuhl Regional Medical Center, Landstuhl/Kirchberg, Germany; and Naval Medical Center, San Diego, California.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 2013Volume 159, Issue 7 Page: 503-504 Keywords Alanine Aminotransferases Ascites Bilirubin Biopsy Blood Brain diseases Drugs Eosinophilia Fatigue Hepatitis Hospitalizations Liver Liver transplantation Nausea Nutrition Phosphatases Prospective studies Pruritus Vomiting ePublished: 1 October 2013 Issue Published: 1 October 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...