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Senna-Induced Hepatitis in a Poor Metabolizer

Ulrich Seybold, MD; Nikola Landauer, MD; Susanne Hillebrand, MS; and Frank-Detlef Goebel, MD
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From Klinikum der Ludwig-Maximilians-Universität, D-80336 Munich, Germany.

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Ann Intern Med. 2004;141(8):650-651. doi:10.7326/0003-4819-141-8-200410190-00024
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Liver function tests and rhein levels over time.

The following tests were also performed and showed no abnormalities: ferritin, copper, ceruloplasmin, and α -proteinase inhibitor levels; antinuclear antibodies, antimitochondrial antibodies, anti–smooth-muscle antibodies, and anti-liver–kidney microsome antibodies. Results of tests for anti–hepatitis B surface antigen and anti–hepatitis A virus antibodies were positive, as expected after immunization, and results of tests for anti–hepatitis C virus/anti–hepatitis E virus, HIV, parvovirus B19, human herpesvirus 7, Coxsackie virus, and leptospirosis were negative. Tests for cytomegalovirus and Epstein–Barr virus showed no acute infection, and results of polymerase chain reaction were negative for hepatitis C virus and GB virus C RNA. Feces were negative for amoebas, schistosoma, and fasciola on microscopy. ALT = alanine aminotransferase; AST = aspartate aminotransferase.

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