Case Report

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

Table 5

Naranjo [8] Causality Scale for Adverse Drug Reactions.

Question/Scoring-Yes/No/Do not know or unavailableCase 1Case 2

1Are there previous conclusive reports on this reaction? 1/0/000
2Did the adverse event appear after the suspected drug was given? 2/-1/022
3Did the adverse reaction improve when the drug was discontinued or a specific antagonist was given? 1/0/011
4Did the adverse reaction appear when the drug was readministered? 2/-1/000
5Are there alternative causes that could have caused the reaction? -1/2/0-1-1
6Did the reaction reappear when a placebo was given? -1/1/000
7Was the drug detected in any body fluid in toxic concentrations? 1/0/000
8Was the reaction more severe when the dose was increased/ increasing, or less severe when the dose was decreased? 1/0/011
9Did the patient have a similar reaction to the same or similar drugs in any previous exposure? 1/0/000

      Total score33

Scoring: >9 : definite adverse drug reaction (ADR).
5–8 : probable ADR.
1–4 : possible ADR.
0 : doubtful ADR.