Drug-induced allergic hepatitis caused by glycyrrhizin, or extract of licorice root

Stronger-Neo-Minophagen C (SNMC) consists of glycine, cysteine and glycyrrhizin, a main component of Kanzo or licorice. It is an established drug for allergic diseases and chronic liver diseases in Japan. We treated a patient who developed SNMC-induced allergic hepatitis, an extremely rare complication with SNMC. The patient was a 33-year-old Japanese man who was admitted to Kyushu University Hospital as a diagnosis of viral meningitis. On admission, laboratory tests revealed slight elevation of SGPT and negative test for HBs antigen and HBc and HA IgM antibody. Although the meningitis was improved, the SGPT level elevated gradually, and intravenous administration of SNMC (20ml/day) was initiated. However, acute elevation of SGOT and SGPT were observed eight days after the initiation of SNMC therapy, when the administration of SNMC was stropped. Two months lator, SGOT and SGPT levels were normalized, and the challenge test with 5ml of SNMC was performed with positive reaction. From these results, the diagnosis of drug-induced allergic hepatitis caused by SNMC was established.