Symptomatic Hepatitis Associated with the Use of Herbal Red Yeast Rice
Authors: Harry Roselle, Andrew Ekatan, Jausheng Tzeng, Mark Sapienza, Jeffrey Kocher
Journal: Annals of Internal Medicine (2008)

Letters7 October 2008Symptomatic Hepatitis Associated with the Use of Herbal Red Yeast RiceHarry Roselle, MD, Andrew Ekatan, MD, Jausheng Tzeng, MD, Mark Sapienza, MD, and Jeffrey Kocher, MDHarry Roselle, MDFrom Englewood Hospital & Medical Center, Englewood, NJ 07631., Andrew Ekatan, MDFrom Englewood Hospital & Medical Center, Englewood, NJ 07631., Jausheng Tzeng, MDFrom Englewood Hospital & Medical Center, Englewood, NJ 07631., Mark Sapienza, MDFrom Englewood Hospital & Medical Center, Englewood, NJ 07631., and Jeffrey Kocher, MDFrom Englewood Hospital & Medical Center, Englewood, NJ 07631.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-7-200810070-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Red yeast rice is a dietary supplement that contains 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors and is used for over-the-counter self-treatment of hyperlipidemia.Objective: To report a case of severe hepatitis associated with use of red yeast rice.Case Report: A 62-year-old woman was brought to the emergency department of our institution with a 10-week history of flu-like symptoms followed by 1 week of nausea, vomiting, diarrhea, chills, and daily fever (temperature, 102 °F). She did not report history of liver disease, blood transfusion, contact with ill persons, or recent travel. She had a history of asthma, allergic rhinitis, ...References1. Thompson Coon JS, Ernst E. Herbs for serum cholesterol reduction: a systematic view. J Fam Pract. 2003;52:468-78. [PMID: 12791229] MedlineGoogle Scholar2. Pasternak RC, Smith SC, Bairey-Merz CN, Grundy SM, Cleeman JI, Lenfant C; American College of Cardiology. ACC/AHA/NHLBI Clinical Advisory on the Use and Safety of Statins. Circulation. 2002;106:1024-8. [PMID: 12186811] CrossrefMedlineGoogle Scholar3. Heber D, Yip I, Ashley JM, Elashoff DA, Elashoff RM, Go VL. Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. Am J Clin Nutr. 1999;69:231-6. [PMID: 9989685] CrossrefMedlineGoogle Scholar4. Mueller PS. Symptomatic myopathy due to red yeast rice [Letter]. Ann Intern Med. 2006;145:474-5. [PMID: 16983142] LinkGoogle Scholar5. Smith DJ, Olive KE. Chinese red rice-induced myopathy. 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