Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh

Table 1

Current case studies: clinical features and medications.

Clinical features	Case $1$	Case $2$
Age (years)	42	53
Gender	Female	Female
Signs	Mild icterus	Increased LFTs
Symptoms	Progressive malaise, nausea	RU${\text{Q}}^{**}$ abdominal pain, fatigue
	Vomiting, dizziness	Lower extremity edema
Stigmata of CLD	Absent	Absent
Medications	Black cohosh	OTC with soy and black cohosh
Indication	Menopausal symptoms	Menopausal symptoms
Dose	Not specified	Not specified
Duration	6 months	8 months
Other medications	Levothyroxine	Dicyclomine; NSAID
Indication	Hyperthyroidism	GI cramps; pain
Dose	0.05 mg daily	Not specified
Duration	Chronic	As needed

LFTs: Liver function tests.
RUQ: Right upper quadrant.
CLD: Chronic liver disease.
OTC: Over the counter drug.
NSAID: Nonsteroidal anti-inflammatory drug.