RT Journal Article SR Electronic T1 Acute liver injury induced by red yeast rice supplement JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e227961 DO 10.1136/bcr-2018-227961 VO 12 IS 3 A1 Lize Loubser A1 Kirstin I Weider A1 Sean M Drake YR 2019 UL http://casereports.bmj.com/content/12/3/e227961.abstract AB A 64-year-old woman previously taking no medications presented with acute hepatitis 6 weeks after starting a red yeast rice supplement to decrease her cholesterol. Red yeast rice is commonly used for hyperlipidaemia as an alternative to statins as it contains monacolin K, the same active chemical in lovastatin. Infectious, toxic and autoimmune causes for injury were ruled out, and liver biopsy was consistent with drug induced liver injury. Red yeast rice appeared to be the cause of her hepatotoxicity. After stopping the supplement and initiating treatment with intravenous methylprednisolone, liver enzymes decreased towards baseline.