Energetic drinks. Lesion of the liver.

Description of the clinical case

Previously, a healthy man at the age of 50 was taken to the emergency room with complaints of poor health, anorexia, abdominal pain, nausea, vomiting, generalized jaundice and darkening of urine. He does not take any medications, but recognizes the fact of consuming 4-5 energy drinks daily for the previous 3 weeks.During physical examination, jaundice of the skin and sclera (see Figure 1a), as well as tenderness in the right hypochondrium, were detected. In blood tests there was an increase in the level of transaminases and signs of chronic HCV-infection. When performing ultrasound of the abdominal cavity organs, an increased echogenicity of the liver and a diffuse thickening of the gallbladder wall (see Fig. 1b) ,. It was decided to conduct a liver biopsy, the results of which indicate the presence of acute inflammation, bridging necrosis and severe cholestasis (see Figure 1c). Supportive treatment was prescribed, followed by a complete regression of symptoms and marked improvement in laboratory performance.

A conclusion was drawn on the development of acute hepatitis due to the abuse of energy drinks.

Discussion.

Approximately 50% of cases of acute renal failure develop against a background of drug intoxication. The list of potentially dangerous preparations and substances is constantly expanding due to the growth of market turnover of plant nutritional supplements. Despite the fact that the potential role of dietary supplements in hepatotoxicity has been repeatedly demonstrated in clinical studies, physicians often pay insufficient attention to this etiologic factor.Among other things, single cases of hepatic dysfunction were described in the literature against the background of abuse of energy drinks. Typically, the latter contain B vitamins and a so-called energy mixture (see Figure 2).

Many of the components of the beverage are presented in ultra-high doses, which creates a great potential for accumulation. First of all it concerns niacin (vitamin B3), which is known for its dose-dependent hepatotoxic effect.

As in the case of drug damage to the liver of another etiology, the main stage of treatment is the elimination of the etiotropic factor.