Background: Drug-induced liver injury (DILI) is caused due to various types of medications, herbs, or other xenobiotics, in the absence of other etiologies. DILI has been observed with different clinical features and biochemical abnormalities. Herbal products are responsible for DILI in many cases (10%). There exists no specialized gold standard method to diagnose or predict DILI, and the disease has been commonly diagnosed with the RUCAM score. Tinospora Cordifolia (Gulvel/Guduchi), which is readily available in the hilly area of western Maharashtra as a wild plant, has been used in Ayurveda for the treatment of hepatotoxicity. Furthermore, it is consumed as an immunemodulator during the COVID 19 pandemic.
Case presentations: During last year, there is a sudden increase in hepatitis cases. We observed 16 patients who consumed Tinospora Cordifolia (Gulvel/Guduchi) and depicted instability in liver function tests. This research found no other reason responsible for such complaints in these patients. All these patients had a RUCAM score greater than six. They had mild to severe level symptoms in which fourteen patients were recovered with supportive care. It was noted that elderly females were affected commonly, in which one mortality case happened secondary to ACLF. The study observed no cases in the family even after the consummation of similar products with similar doses.
Conclusion: Tinospora Cordifolia (Gulvel/Guduchi) can cause mild to severe grade hepatotoxicity with high doses, most probably in genetically susceptible elderly patients. Additionally, the study also states that mortality is rare. However, to confirm this observation and to provide prompt details, more research must be carried out.
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