Acute Hepatitis due to Garcinia Cambogia Extract, an Herbal Weight Loss Supplement

Table 1

CIOMS/RUCAM scale.

Criteria	Score
1. Time from drug intake until reaction onset
5-90 days	+2
<5 or >90 days	+1
2. Time from drug withdrawal until reaction onset
<15 days	+1
>15 days	0
3. Alcohol risk
Present	+1
Absent	0
4. Age risk factor
>55 years	+1
<55 years	0
5. Course of reaction
>50% improvement within 8 days	+3
>50% improvement within 30 days	+2
Worsening or <50% improvement in 30 days	-1
6. Concomitant therapy
Time to onset incompatible	0
Time to onset compatible but with unknown reaction	-1
Time to onset compatible but known reaction	-2
Role proved in the case	-3
None or information not available	0
7. Exclusion of non-drug-related causes
Rule out	+2
“Possible” to “not investigated”	0
Probable	-3
8. Previous information on hepatotoxicity
Reaction unknown	0
Reaction published but unlabeled	+1
Reaction labeled in the product's characteristics	+2
9. Response to re-administration
Positive	+3
Compatible	+2
Negative	-2
Not available or not interpretable	0
Plasma concentration of drug known as toxic	+3
Validated laboratory test with high specificity, sensitivity, and predictive values	Positive: +3
	Negative: -3