Herb-Induced Liver Injury (HILI) Associated With Asowosi (Momordica charantia): A Case Report

TL;DR

A 38-year-old man developed liver injury linked to using Asowosi (bitter melon), highlighting the need to consider herbal remedies in diagnosing unexplained liver issues.

Contribution

This case report is one of the few documenting HILI caused by Asowosi, emphasizing its under-recognized hepatotoxic potential.

Findings

A patient's elevated liver enzymes were attributed to Asowosi use after ruling out other causes.

Liver histology confirmed herb-induced liver injury following discontinuation of the herbal remedy.

The case highlights the importance of considering herbal products in differential diagnoses of liver injury.

Abstract

Herbal remedies are widely used for various health purposes, yet their potential to cause adverse effects is often overlooked. Asowosi, also known as bitter melon, is one such plant incorporated into traditional medicine practices for blood sugar management.

This case study presents the comprehensive findings regarding a 38-year-old male who initially presented with transaminitis and weakness. The cause of the patient’s elevated liver enzymes was unclear, as he reported occasional alcohol consumption. However, upon further questioning, he disclosed two to three weeks of herbal remedy use, including Asowosi. The supplement had been selected for its accessibility and familiarity. While the exact mechanism of injury in this case remains unclear, herbal products can have physiologic effects that warrant consideration during diagnostic evaluation.

Determining the etiology of this patient’s acute liver injury was challenging due to the limited clinical information available on Asowosi. After supportive care and discontinuation of the herbal remedies, the patient’s condition improved, and liver histology supported a diagnosis of herb-induced liver injury (HILI). This case underscores the importance of including herbal and nonprescription products in the differential diagnosis of unexplained liver injury and encourages prompt recognition and reporting of similar cases.

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