Year 2024 / Volume 116 / Number 7
Letter
Drug-induced liver injury associated to red yeast rice

384-385

DOI: 10.17235/reed.2023.9797/2023

María Desirée García-García, Francisco Bellido Muñoz, Patricia Cordero Ruiz, Paula Fernández Álvarez, María Isabel Carmona Soria, Ángel Caunedo Álvarez,

Abstract
Hepatotoxicity is defined as a liver injury induced by a drug or a non-pharmacological agent like herbal medications or dietary supplements. Red yeast rice is rich in monacolin K, which has the same chemical structure as lovastatin, reason why it has been used for the management of hiperlipidemia. A 62 years old woman presented to the emergency service with 38.5ºC fever, coluric orine and loss of weight in the previous 3 weeks. The patient was taking RYR since the week before to the initial symptoms. Mixed hepatocellular and cholestatic acute hepatitis was diagnosed. Autoimmune liver serology resulted positive. Total DILI RECAM Score was 8 (highly probable DILI). Conservative treatment with exclusion of RYR was decided and during follow-up bilirubin and transaminases gradually dropped off. It has been reported a few cases of hepatitis associated to the use of RYR, promoted by a toxic or immunogenic metabolite. Cross-reactions may justify positive autoantibodies so hepatotoxicity should not be discard as a diagnose.
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References
1. Serras AS, Rodrigues JS, Cipriano M, Rodrigues AV, Oliveira NG, Miranda JP. A Critical Perspective on 3D Liver Models for Drug Metabolism and Toxicology Studies. Front Cell Dev Biol. 2021 Feb 22;9:626805. doi: 10.3389/fcell.2021.626805.
2. Wang TJ, Lien AS, Chen JL, Lin CH, Yang YS, Yang SH. A Randomized Clinical Efficacy Trial of Red Yeast Rice (Monascus pilosus) Against Hyperlipidemia. Am J Chin Med. 2019;47(2):323-335. doi: 10.1142/S0192415X19500150.
3. Meunier L, Larrey D. Drug-Induced Liver Injury: Biomarkers, Requirements, Candidates, and Validation. Front Pharmacol. 2019 Dec 11;10:1482. doi: 10.3389/fphar.2019.01482.
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Citation tools
García-García M, Bellido Muñoz F, Cordero Ruiz P, Fernández Álvarez P, Carmona Soria M, Caunedo Álvarez Á, et all. Drug-induced liver injury associated to red yeast rice. 9797/2023


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Publication history

Received: 21/06/2023

Accepted: 27/06/2023

Online First: 14/07/2023

Published: 08/07/2024

Article Online First time: 23 days

Article editing time: 383 days


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