A 50-year-old man presented to the emergency department with acute hepatitis that was likely caused by excessive energy drink consumption, according to a case study published in BMJ Case Reports.
The previously healthy man presented with a 2-week history of malaise, anorexia, abdominal pain, nausea, vomiting, scleral icterus, generalized jaundice, and dark urine. He had no family history of liver disease and had not seen a primary care provider in years. Prior to hospital admission, he was taking no prescription or over-the-counter medications.
The patient had no changes in diet and was not using alcohol, tobacco, or illicit drugs, but he did drink 3 to 4 energy drinks daily for 3 weeks prior to presentation. The initial physical examination revealed normal vital signs, scleral icterus, jaundice, and right upper quadrant abdominal tenderness.
The RUQ ultrasound revealed an echogenic liver without cirrhosis, common bile duct obstruction, or gallstones. The ultrasound also showed diffuse gallbladder wall thickening, and a liver biopsy confirmed severe acute hepatitis with bridging necrosis and marked cholestasis.
The patient had high levels of serum folate and vitamin B12 that were consistent with his high consumption of energy drinks. “His liver injury was directly subsequent to excessive consumption of energy drinks, and resolved on discontinuation of the product,” the study authors wrote.
The patient was treated supportively, and his symptoms were resolved by the third day of hospitalization. He underwent daily liver function tests to ensure that he did not develop liver failure, and the researchers noted an improvement in his laboratory abnormalities. After 6 hospital days, the patient was discharged and tolerated a regular diet without malaise, anorexia, abdominal pain, or nausea and vomiting.
“By alerting physicians to this phenomenon, we hope patients will be educated about the potential risks of energy drink overconsumption, and thus, many unnecessary liver injuries will be prevented, or at least promptly identified and treated appropriately,” the authors noted.
- Harb JN, Taylor ZA, Khullar V, Sattari M. Rare cause of acute hepatitis: a common energy drink. BMJ Case Rep. 2016; doi:10.1136/bcr-2016-216612.