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Kaneko R, Ohishi C, Kim M, et al. Two cases of food additive-induced severe liver damage associated with positive results on lymphocyte stimulation test and for antinuclear antibodies. Clin J Gastroenterol. 2012;5(4):268-74doi: 10.1007/s12328-012-0312-7.
Kaneko, R., Ohishi, C., Kim, M., Shiina, M., Kusayanagi, S., Ogawa, M., Munakata, K., Mizuno, K., & Sato, Y. (2012). Two cases of food additive-induced severe liver damage associated with positive results on lymphocyte stimulation test and for antinuclear antibodies. Clinical journal of gastroenterology, 5(4), 268-74. https://doi.org/10.1007/s12328-012-0312-7
Kaneko, Rena, et al. "Two cases of food additive-induced severe liver damage associated with positive results on lymphocyte stimulation test and for antinuclear antibodies." Clinical journal of gastroenterology vol. 5,4 (2012): 268-74. doi: https://doi.org/10.1007/s12328-012-0312-7
Kaneko R, Ohishi C, Kim M, Shiina M, Kusayanagi S, Ogawa M, Munakata K, Mizuno K, Sato Y. Two cases of food additive-induced severe liver damage associated with positive results on lymphocyte stimulation test and for antinuclear antibodies. Clin J Gastroenterol. 2012 Aug;5(4):268-74. doi: 10.1007/s12328-012-0312-7. Epub 2012 Jun 04. PMID: 26182392.
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Clin J Gastroenterol. 2012 Aug;5(4):268-74. doi: 10.1007/s12328-012-0312-7. Epub 2012 Jun 04.

Two cases of food additive-induced severe liver damage associated with positive results on lymphocyte stimulation test and for antinuclear antibodies.

Clinical journal of gastroenterology

Rena Kaneko, Chitose Ohishi, Miniru Kim, Masaaki Shiina, Satoshi Kusayanagi, Masazumi Ogawa, Kazuo Munakata, Kyoichi Mizuno, Yuzuru Sato

Affiliations

  1. Department of Gastroenterology and Hepatology, Kanto Rosai Hospital, Japan Labor Health and Welfare Organization, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510, Japan. [email protected].
  2. Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan. [email protected].
  3. Department of Gastroenterology and Hepatology, Kanto Rosai Hospital, Japan Labor Health and Welfare Organization, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510, Japan.
  4. Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan.

PMID: 26182392 DOI: 10.1007/s12328-012-0312-7

Abstract

Two cases of severe liver injury and positive result for antinuclear antibodies induced by food additives are reported. The first patient reported long-term intake of Mabo Ramen(®) noodle soup, nutritional supplements, and over-the-counter drugs. Total bilirubin, aspartate aminotransferase, and alanine aminotransferase were 9.6 mg/dL, 1,048, and 1,574 IU/L, respectively. Antinuclear antibody was 80×. The drug-induced lymphocyte stimulation test (DLST) was positive for Mabo Ramen(®) and its additives such as Xanthan gum, guar gum, and Doubanjiang. Histologic examination of a liver biopsy specimen showed lymphocyte infiltration and necrosis. The autoimmune hepatitis score was 3. The second patient reported intake of dietary supplements, including Bimore C(®) and Chokora BB(®). Laboratory tests revealed that total bilirubin was 9.8 mg/dL, aspartate aminotransferase was 1,130 IU/L, and alanine aminotransferase was 1,094 IU/L. Antinuclear antibody was 320×. Co-existing pancreatic damage was confirmed by the findings on abdominal CT and elevation of serum lipase, span-1, and DUPAN-2. DLSTs were positive for both supplements. These two supplements contained additives such as titanium oxide, magnesium stearate, and hydroxypropylcellulose. DLSTs for all three additives were positive. Histologic examination revealed periportal necrosis and lymphocyte infiltration of lobular and portal areas. These two cases demonstrate that repeating DLSTs is useful for identifying causative constituents in foods and supplements.

Keywords: DUPAN-2; Drug-induced lymphocyte stimulation test; Food additives; Hepatitis; Pancreatitis

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