Epsom salt may cause liver injury in predisposed patients

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A 38-year old nonalcoholic patient consumed Epsom salt in large quantities for a short period of time and developed jaundice and steatohepatitis.
A 38-year old nonalcoholic patient consumed Epsom salt in large quantities for a short period of time and developed jaundice and steatohepatitis.

(HealthDay News) — Epsom salt intake can lead to severe liver injury in predisposed patients, according to a case study published online Oct. 2 in BMJ Case Reports.

Cyriac Abby Philips, MD, from PVS Memorial Hospital in India, and colleagues documented the case of a patient who consumed Epsom salt in large quantities within a short period of time (3 tablespoons with lukewarm water for 15 days) as naturopathic treatment for gallstones.

The patient, a 38-year-old nonalcoholic man without diabetes, presented with jaundice. Blood investigations revealed a platelet count of 190, total bilirubin of 12.8, direct bilirubin of 6.9, aspartate aminotransferase of 508, alanine aminotransferase of 228, alkaline phosphatase of 178, albumin of 4.2, and international normalized ratio of 1.1. Tests showed no sign of viral hepatitis viruses, cytomegalovirus, Epstein-Barr, herpes simplex viruses, autoimmune hepatitis, or IgG4. Computed tomography of the upper abdomen showed only hepatomegaly with mild periportal oedema. Percutaneous liver biopsy revealed dense portal-based expansile reactive fibrosis and associated necrosis with mixed cellular inflammation without evidence of acute drug-induced liver injury. Unlike cases of chronically exposed patients, he demonstrated a predominantly necrotic and dense reactive fibrotic type of injury.

"We believe that underlying nonalcoholic steatohepatitis potentiated extensive liver injury in our patient, which resolved on stopping the offending agent," conclude the authors.

Reference

Philips CA, Paramaguru R, Mahadevan P, Augustine P. Severe liver injury due to Epsom salt naturopathy. BMJ Case Rep. 2017 Oct 2. doi: 10.1136/bcr-2017-221718


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