Acute hepatitis in a woman following excessive ingestion of an energy drink: a case report

Vivekanandarajah, Abhirami; Ni, Shirley; Waked, Alain

doi:10.1186/1752-1947-5-227

Cited by 41 publications

(36 citation statements)

References 3 publications

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“…(25) A case has been reported of a woman that presented with jaundice, abdominal pain and highly elevated liver enzymes following energy drink overconsumption. (26) Huang et al reported the same finding in a 36-year-old man. (27) Further studies are needed to determine, which individuals are highly susceptible and the underlying mechanism by which energy drinks cause hepatic injury.…”

Section: Cardiovascular Effectsupporting

confidence: 52%

Energy Drink Consumption : Beneficial and Adverse Health Effects

Alsunni¹

2015

IJHS

100

104

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Consumption of energy drinks has been increasing dramatically in the last two decades, particularly amongst adolescents and young adults. Energy drinks are aggressively marketed with the claim that these products give an energy boost to improve physical and cognitive performance. However, studies supporting these claims are limited. In fact, several adverse health effects have been related to energy drink; this has raised the question of whether these beverages are safe. This review was carried out to identify and discuss the published articles that examined the beneficial and adverse health effects related to energy drink. It is concluded that although energy drink may have beneficial effects on physical performance, these products also have possible detrimental health consequences. Marketing of energy drinks should be limited or forbidden until independent research confirms their safety, particularly among adolescents. Disclosure of benefit:This work was not supported by any drug or commercial company. Manufacturers recently have shifted their consumer focus from athletes to young people. Energy drinks are aggressively marketed in places popular with teens and young adults. Approximately, two thirds of energy drink consumers are 13-35 years old, and boys are two thirds of the market. (4) In the U.S., energy drinks are the second most common dietary supplement used by young people; about 30% consume energy drinks on a regular basis. (5) The popularity of energy drinks in the Kingdom of Saudi Arabia does not seem to differ from other parts of the world. Around half of the Saudi University students who participated in a survey admitted to regular consumption of energy. (6) Energy drinks are designed to give an "energy boost" to the drinker by a combination of stimulants and energy boosters. The major constituent in most energy drinks is caffeine. They usually contain 80-150 mg of caffeine per 8 ounces, which is equivalent to 5 ounces of coffee or two 12-ounce cans of caffeinated soda. (7) Most of the brands on the market contain large amounts of glucose while some brands offer artificially sweetened versions. Other commonly used constituents are taurine, methylxanthines, vitamin B, ginseng, guarana, yerba mate, acai, maltodextrin, inositol, carnitine, creatine, glucuronolactone, and ginkgo biloba. CorrespondenceCurrently, significant concerns have been raised about the safety of these products. There have been several reports that showed adverse health effects associated with energy drink. Despite this, manufactures of energy drinks claim these products are suitable for consumers

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Section: Cardiovascular Effectsupporting

confidence: 52%

Energy Drink Consumption : Beneficial and Adverse Health Effects

Alsunni¹

2015

IJHS

100

104

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“…Vitamins and nutrients, such as niacin, are present in quantities that greatly exceed the recommended daily intake, lending to their high risk for harmful accumulation and toxicity. 3 To the best of our knowledge, only one other case report has previously been published in the literature describing acute hepatitis related to energy drinks; 3 herein, we report the second case. Appreciation of this under-recognised phenomenon in clinical practice will decrease prevalence and potentially fatal delays in discontinuation of the offending agent.…”

Section: Introductionmentioning

confidence: 74%

“…To the best of our knowledge, only one other case report has previously documented acute hepatitis from overconsumption of energy drinks. 3 We present a second case of a patient who presented with acute hepatitis secondary to energy drink consumption. In the absence of a rechallenge, the association is probable/likely (according to the WHO-UMC causality categories) as the transaminitis occurred with a reasonable time sequence to the energy drink intake, was unlikely to be attributed to other drugs or concurrent diseases and followed a clinically reasonable response to withdrawal.…”

Section: Discussionmentioning

confidence: 99%

“…6 Energy drinks contain a mixture of B vitamins and an 'energy blend'. 3 As listed on the manufacturer's label, the energy blend includes taurine, glucuronic acid, malic acid, N-acetyl l-tyrosine, l-phenylalanine, caffeine and citicoline. The B vitamins involved include high amounts of vitamin B 12 (cyanocobalamin), B 9 (folic acid), B 6 ( pyridoxine) and vitamin B 3 (niacin).…”

Section: Discussionmentioning

confidence: 99%

“…7 Our patient's daily intake was ∼160-200 mg daily, which is below the threshold expected to cause toxicity, but similar to the previously reported energy drink-associated acute hepatitis (around 300 mg of niacin daily). 3 Hepatotoxicity could be due to some of the other compounds within the beverage, for which there are limited toxicity data. Furthermore, little is known about the interactions between the different components of these beverages.…”

Section: Discussionmentioning

confidence: 99%

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Rare cause of acute hepatitis: a common energy drink

et al. 2016

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A previously healthy man aged 50 years presented with malaise, anorexia, abdominal pain, nausea, vomiting, generalised jaundice, scleral icterus and dark urine. He was not on any prescription or over-the-counter medications, but reported drinking 4–5 energy drinks daily for 3 weeks prior to presentation. Physical examination revealed jaundice and right upper quadrant abdominal tenderness. Laboratory studies were remarkable for transaminitis and evidence of chronic hepatitis C infection. Ultrasound scan demonstrated an echogenic liver and diffuse gallbladder wall thickening. Liver biopsy showed severe acute hepatitis with bridging necrosis and marked cholestasis. The patient was treated supportively with complete resolution of his symptoms and marked improvement in his laboratory abnormalities. The development of acute hepatitis in this patient was likely secondary to excessive energy drink consumption. Energy drinks as well as other herbal/over-the-counter supplements should be considered by clinicians in the workup of patients with acute hepatitis, particularly once other aetiologies have been excluded.

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