Case series and review of Ayurvedic medication induced liver injury

Table 2 RUCAM for liver injury

	Possible Score	Patient 1	Patient 2	Patient 3
Time to onset	+ 2	+ 2	+ 1	+ 2
5–90 days
< 5 or > 90 days	+ 1
Course of ALT after cessation of herb		+ 2	+ 3	+ 2
Decrease > 50% within 8 days	+ 3
Decrease > 50% within 30 days	+ 2
Risk factors
Alcohol +	−1
Alcohol -	0	0	0	0
Age > 55 years	+ 1	+ 1
Age < 55 years	0		0	0
No concomitant drugs/herbs		0	0	0
All causes-group I and II-ruled out		+ 2	+ 2	+ 2
Previous hepatotoxicity		+ 1	+ 1	+ 1
Reaction labeled in the product characteristics	+ 2
Reaction published but not labeled	+ 1
Response to unintentional re-exposure		0	0	0
Total score for the case		+ 8	+ 7	+ 7

RUCAM score causality levels < 0 excluded causality; 1–2 unlikely; 3–5, possible; 6–8, probable; and > 9, highly probable (ref [26])

ISSN: 2662-7671