Methylprednisolone for Swietenia macrophylla seeds-induced liver injury: A report of two cases.

Swietenia macrophylla seeds (SMS), as a traditional medicine, are widely used against diabetes, hypertension, and malaria. To date, knowledge about the safety of human consumption remains limited. We herein reported two cases of drug-induced liver injury (DILI) caused by SMS. Both patients had positive antinuclear antibodies. Hepatotoxicity of SMS is characterized by elevated alanine aminotransferase and obvious autoimmune-like hepatitis. Furthermore, the 2nd biopsy at the 3rd year of methylprednisolone treatment showed normal liver tissue, and then methylprednisolone was withdrawn. No recurrence occurred during one-year follow-up after methylprednisolone withdrawal. SMS may increase the risk of liver damage for patients with potential immune disorders, and patients with SMS-related DILI may benefit from methylprednisolone.