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Kunal K Dalal, Thomas Holdbrook, Steven R PeikinCASE REPORT1205 November 8, 2017 | Volume 9 | Issue 31 | WJH | www.wjgnet.comAyurvedic drug induced liver injuryKunal K Dalal, Department of Medicine, Cooper Medical School of Rowan University, Cooper University Hospital, Camden, NJ 08103, United StatesThomas Holdbrook, Department of Pathology, Cooper Medical School of Rowan University, Cooper University Hospital, Cam­den, NJ 08103, United StatesSteven R Peikin, Division of Gastroenterology and Liver Disease, Cooper Medical School of Rowan University, Cooper University Hospital, Camden, NJ 08103, United States Author contributions: All authors took care of the patient medically; Dalal KK analyzed and drafted the report; Holdbrook T and Peikin SR made critical appraisals of the report.Institutional review board statement: Cooper Health System Institutional Review Board does not require IRB review for Case Reports less than 5 patients. Informed consent statement: Informed consent was acquired from the patient.Conf l ict-of-interest statement: None of the authors have any fi nancial disclosures or conf l icts of interest.Open-Access: This article is an open­access article which was selected by an in­house editor and fully peer­reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY­NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non­commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non­commercial. See: http://creativecommons.org/licenses/by­nc/4.0/Manuscript source: Unsolicited manuscriptCorrespondence to: Kunal K Dalal, MD, Department of Medicine, Cooper Medical School of Rowan University, Cooper University Hospital, 1 Cooper Plaza, Camden, NJ 08103, United States. kunald89@gmail.comTelephone: +1­856­3422000Fax: +1­844­5116895Received: May 3, 2017Peer-review started: May 4, 2017First decision: June 15, 2017Revised: June 28, 2017Accepted: August 3, 2017Article in press: August 3, 2017Published online: November 8, 2017AbstractDrug induced liver injury is responsible for 50% of acute liver failure in developed countries. Ayurvedic and homeopathic medicine have been linked to liver injury. This case describes the first documented case of Punarnava mandur and Kanchnar guggulu causing drug induced liver injury. Drug induced liver injury may be difficult to diagnosis, but use of multi-modalities tools including the ACG algorithms, causative assessment scales, histological fi ndings, and imaging, is recommended. Advanced imaging, such as magnetic resonance chol-angiopancreatography, may possibly have a greater role than previously reported in literature. Key words: Ayurvedic; Punarnava mandur; Kanchnar guggulu; Drug induced liver injury; T2 heterogeneous hype-rintensity; Roussel Uclaf Causality Assessment Method© The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.Core tip: Drug induced liver injury is diff i cult to diagnose. Certain ayurvedic medications are commonly used without full knowledge of their side effects. This article not only represents the first documented case report of drug induced liver injury secondary to Punarnava mandur and Kanchnar guggulu, but it also demonstrates the possible role for advanced imaging modalities.Dalal KK, Holdbrook T, Peikin SR. Ayurvedic drug induced liver injury. World J Hepatol 2017; 9(31): 1205­1209 Available from: URL: http://www.wjgnet.com/1948­5182/full/v9/i31/1205.htm DOI: http://dx.doi.org/10.4254/wjh.v9.i31.1205Submit a Manuscript: http://www.f6publishing.comDOI: 10.4254/wjh.v9.i31.1205World J Hepatol 2017 November 8; 9(31): 1205-1209ISSN 1948-5182 (online)