Department of Pharmacy, the People′s Hospital of Pingyi County,Shandong Province, Pingyi 273000, China; Department of Pharmacy, Linyi People′s Hospital, Shandong University, Shandong Province, Linyi 276003, China
Abstract：A 58-year-old female patient took orlistat 0.12 g orally once daily by herself due to obesity. After 13 months, she developed fatigue and anorexia. Laboratory tests showed alanine aminotransferase(ALT) 1 603 U/L, aspartate aminotransferase(AST) 1 265 U/L, alkaline phosphatase(ALP) 310 U/L, direct bilirubin(DBil) 8.4 μmol/L, and indirect bilirubin(IBil) 13.4 μmol/L. She was diagnosed with liver injury. Orlistat was discontinued, considering its relationship with the liver injury. And an IV infusion of diammonium glycyrrhizinate 150 mg (added to 250 ml of glucose injection) once daily was given. Two days later, the diammonium glycyrrhizinate was replaced by IV infusion of magnesium isoglycyrrhizinate 100 mg (added to 100 ml of 0.9% sodium chloride injection) once daily because that the symptoms did not relieve. After 6 days of treatment with magnesium isoglycyrrhizinate, the patient′s symptoms relieved and she had ALT 124 U/L, AST 73 U/L, ALP 73 U/L, DBil 3.1 μmol/L, and IBil 7.3 μmol/L. After 1 month, liver function tests showed ALT 30 U/L, AST 57 U/L, ALP 93 U/L, DBil 3.0 μmol/L, and IBil 11.8 μmol/L.
