Case Report

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

Table 4

Duration of Illness and black cohosh use, liver function tests, autoimmune markers and histology.

Case 2

Time of use to illness: 8 months**

Time of use to discontinuation: 8 months**

Time of presentation to liver clinic**

Duration in months44.55


Liver function tests (normal values)
 Total bilirubin (0.8–1.2 mg/dL)
 ALT (5–40 U/L)4436030
 AST (10–40 U/L)4785038
 ALP (30–120 U/L)18815398
INR (0.8–1.2)2.01.3

Autoimmune antibodies
 Anti-nuclear antibodyNegative1 : 20
 Anti-smooth muscle antibodyNegative
Liver biopsy findings

 Other findingsDisarray, apoptosis

Portal and periportal
 Cholangiolar proliferationModerate
 Infiltrate severityModerate
 Infiltrate predominant typePlasmacytic
Fibrosis Fibronecrosis