BMJ Case Reports 2016; doi:10.1136/bcr-2016-216612

Rare cause of acute hepatitis: a common energy drink

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  1. Maryam Sattari4
  1. 1Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
  2. 2Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
  3. 3Division of Gastroenterology, Hepatology, & Nutrition, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
  4. 4Division of General Internal Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
  1. Correspondence to Dr Jennifer Nicole Harb, jennifer.harb{at}
  • Accepted 14 October 2016
  • Published 1 November 2016


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.


  • Contributors The authors JNH, ZAT, VK and MS have contributed sufficiently to the project and have met all criteria to be included as authors. All authors have no relevant financial interest in this manuscript and no activities, affiliations or relationships to disclose. All authors have not published or submitted any related papers from the same study.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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