Hyperbilirubinemia and transaminitis in hepatitis A: case report on early remission through ayurveda interventions

Abstract

Hepatitis A is a common cause for acute hepatitis and jaundice. It is mostly self-limiting requires no or suppurative treatment and very rare cases prolong jaundice, liver failure and death. Prolonged jaundice types of cases are mostly going to folk healers and herbalist. Ayurveda has no recordable evidence of course of treatment in Hepatitis A. Therefore, this case paper will be a notable evidence for Ayurveda in hepatitis A. A 43-year female came to hospital with an one week history of lethargy, anorexia, weight loss and yellow discoloration of urine. The patient has Hepatitis A (HAV) IgM antibody positive with other viral profile negative and elevated bilirubin(6.28mg/dl) and high transaminase (SGOT-824U/L and SGPT 1263 U/L). Arogyavardhini Vati, Liv 52Hb and Phalatrikadi Kwatha were administrated in its standard doses as these regimen have Agnideepak(Carminative), Srotosothaka (channel purifier), Mrudu virechana ( Mild purgative)properties, but no signicant change in liver function test . then ( Siddha Makardwaja Rasa) is added to reduce liver inflammation and possible involvement of cholangitis. The physical strength , appetite was normalised along with normalisation of bilirubin and liver transaminase within three weeks of the therapy. The combination of therapy may reduce the bile acid cytotoxicity of bile and, possibly, decrease of the concentration of hydrophobic bile acids in the cholangiocyte. As Siddha Makardwaja special is in metallic oxide form (Au/HgO), it may be acts as an anti-inflammatory drug by reducing pro inflammatory cytokine expression, blocking leucocyte adhesion and decreasing oxidative stress due to infection. This case report is preliminary evidence for further stresses the significance of Siddha Makardwaja Rasayana along with other Ayurveda formulations in early remission of high bilirubin and liver transaminase in Hepatitis A infection. This treatment regimen can be used for local epidemic of Hepatitis A for appropriate Ayurveda management after randomised clinical trial.