Vini Patel, DO1, Aaron Teklesenbet, MD2, Jacques Charlier, MD2, Anand Shah, MD3, Sanjay Ponkshe, MD1 1Atlanta VA Medical Center, Decatur, GA; 2Morehouse School of Medicine, Atlanta, GA; 3Kaiser Permanente, Atlanta, GA Introduction: Drug induced liver injury(DILI) is commonly due to prescription medications like amoxicillin. However, supplements are now an emerging cause of DILI. Turmeric is thought to be safe with anti-inflammatory and antioxidant properties. Turmeric contains curcuminoids that have been shown to inhibit leukotriene synthesis that theorized to inhibit intracellular kinases, an antineoplastic property. Despite these benefits, there are case reports and small studies that suggest acute liver injury (ALI). Our case of DILI is unique as it was most likely induced by high bioavailability turmeric supplementation.
Case Description/
Methods: A 48 year old male with history of alcohol use presented to the ER due to yellowing of his skin. Over the past two weeks, he reported general malaise, dark urine, light colored stool, and yellowing of the skin and eyes. He started taking supplements turmeric 1000mg BID and beet root 1000mg daily one month ago but stopped taking them a week ago. He denied recent travel, sick contacts, new medications, and pet exposure. He has not had any alcohol use in the last two years. Vital signs were stable and physical exam remarkable for jaundice and scleral icterus. Labs: AST 1516 and ALT 2418, total bilirubin 16.1, alkaline phosphatase 155, CBC unremarkable. Hepatitis B, C, and A serologies, syphilis RPR, HIV, VZV IgM, ANA, ASMA, cerulopasmin, CMV, LKM, ethanol, acetaminophen, UDS were all unremarkable. Abdominal ultrasound and CT abdomen showed normal liver morphology with patent main portal vein, no signs of biliary duct dilation or cholecystitis. Turmeric was discontinued and labs normalized after weeks. Discussion: This is a unique case of turmeric associated DILI. Turmeric induced DILI can show up after weeks to months. Injury is a hepatocellular pattern, and the mechanism may be due to interaction of curcuminoids with HLA B 3501, which leads to an autoimmune - like reaction. The HLA B 3501 allele is also linked to liver injury by green tea. In contrast, beet root supplements have not previously been identified as a cause of ALI. Fortunately, most causes of turmeric induced DILI resolve within a few months of stopping turmeric. This rare cause of hepatic injury emphasizes the importance of broad differentials and comprehensive medication reconciliation, including OTCs and supplements. With the popularity of turmeric supplementation rising, this may become a more common occurrence.
Disclosures: Vini Patel indicated no relevant financial relationships. Aaron Teklesenbet indicated no relevant financial relationships. Jacques Charlier indicated no relevant financial relationships. Anand Shah indicated no relevant financial relationships. Sanjay Ponkshe indicated no relevant financial relationships.
Vini Patel, DO1, Aaron Teklesenbet, MD2, Jacques Charlier, MD2, Anand Shah, MD3, Sanjay Ponkshe, MD1. P3825 - Turmeric - The Golden Spice That May Deceive!, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
