Syncytial giant cell hepatitis is an uncommon form of chronic hepatitis in
adults, although it has been reported in association with viral infection (
including HCV and HIV infection), drug reactions and autoimmune disorders.
We here report a very unusual case of giant cell chronic hepatitis in a 26-
old-woman, who had been taking a herbal remedy (ISABGOL) for chronic consti
pation. The presence of viral and metabolic diseases has been excluded; an
autoimmune etiology was very unlikely as the autoimmunity test remained neg
ative during the year of follow-up and the total disease score normalized (
from 13 to 8) without corticosteroid treatment. The causative role of the h
erbal remedy was further supported by the spontaneous and dramatic clinical
, biochemical and histologic improvement observed following its withdrawal,
despite the absence of any treatment.