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ISSN: 2167-1052

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Case Report

Acute Hepatitis Caused by Green Tea Infusion: A Case Report

Arzenton E1, Magro L1, Paon V2, Capra F2, Apostoli P3, Guzzo F4, Conforti A1 and Leone R1*
1Pharmacology Unit, Department of Public Health and Community Medicine, University of Verona, Verona, Italy
2Section of Internal Medicine, Department of Biomedical and Surgical Science, University of Verona, Verona, Italy
3Institute of Occupational Medicine and Industrial Hygiene, Department of Experimental and Applied Medicine, University of Brescia, Brescia, Italy
4Department of Biotechnology, University of Verona, Verona, Italy
*Corresponding Author : Roberto Leone
Department of Public Health and Community Medicine
Pharmacology Unit, University of Verona
LA Scuro 10, 37134 Verona, Italy
Tel: +39 0458124706
Fax: +39 0458124876
E-mail: [email protected]
Received November 14, 2014; Accepted November 30, 2014; Published December 03, 2014
Citation: Arzenton E, Magro L, Paon V, Capra F, Apostoli P, et al. (2014) Acute Hepatitis Caused by Green Tea Infusion: A Case Report. Adv Pharmacoepidemiol Drug Saf 3:170. doi:10.4172/2167-1052.1000170
Copyright: © 2014 Arzenton E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The green tea is obtained by an unfermented process of leaves of Camellia sinensis and the main chemical components are polyphenols, particularly epigallocatechin-3-gallate and epicatechin-3-gallate that could be associated to adverse hepatic reactions. We present a case of acute hepatitis caused by the use of green tea.A 62-year-old woman was hospitalized because of the persistent high levels of liver function tests. After the hospitalization a lot of instrumental exams and blood checks were performed. The search of metallic elements in the used green tea infusions was performed using an inductively coupled-plasma mass spectrometry; high performance liquid chromatography-electro spray ionization-mass spectrometry analysis was done to characterize the metabolite profiles of the infusions of green tea. The blood check showed in particular alanine aminotransferase (780 U/L) and total bilirubin (1.15 mg/dL) levels abnormal. The abdominal echography and other blood parameters were normal, but liver biopsy described a “drug toxic damage”. Every day over the previous 9 months the patient drank two or three cups of several brands of green tea infusions and she stopped this behavior when abdominal pain was persistent. Her medical history didn’t report the use of other drugs or toxic products. After four months of stopping the use of green tea infusions, the liver function tests were normalized. The presence of metallic elements in tea infusion cannot justify the observed liver toxicity in our patient. Instead, the highest levels of epigallo catechin methyl gallate derived from epigallocatechin-3-gallate observed in one of the samples consumed by the patient, arise a possible correlation between some of the catechins in green tea and the hepatotoxic effect. It is conceivable that the mechanism of damage can be idiosyncratic-metabolic or allergic.

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