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Original ArticleOpen Access
Acute Hepatitis Associated with Barakol
Hongsirinirachorn M 
,
Threeprasertsuk S ,
Chutaputti A
,
Threeprasertsuk S ,
Chutaputti A Barakol is a natural anxiolytic extracted from
Cassia siamea,
known as
"Khi-lek"
in Thai-
land. The authors studied the adverse effects of Barakol in 12 healthy Thai patients, aged 29-81 years
(mean 52.5) who took Barakol 3-180 days (mean 76.9). Eight of them were admitted with the first
episode of anorexia and jaundice for 4-60 days (mean 14.3) after taking 20-40 mg/day (2-4 tablets)
of Barakol. There was no relationship between degree of symptom and dosage/duration of Barakol
intake. Three asymptomatic cases were detected with increased aminotransferase from a routine check-
up, including an 81 year old female who took half of the dosage for 120 days. The last one was a male
patient who presented with low-grade fever and nausea and vomiting. All patients had neither a history
of chronic liver disease nor known hepatotoxic substance ingestion. On admission, the mean total
bilirubin was 5.7 mg/dl and liver function test (LFf) revealed moderate to severe hepatitis (Aspatate
amino transferase (AST) range 111-1,473 U/L: mean= 692). None of them had detected viral markers.
Liver biopsy was done in 3 cases and the histopathological findings were compatible with interface
hepatitis. Two non-biopsy cases developed recurrent transaminitis after one-week re-challenging
without informing the physician. Their symptoms and LFf completely improved within 2-20 weeks
(mean 5.9) after Barakol abstinence.
Key word : Barakol, Hepatitis
Cassia siamea,
known as
"Khi-lek"
in Thai-
land. The authors studied the adverse effects of Barakol in 12 healthy Thai patients, aged 29-81 years
(mean 52.5) who took Barakol 3-180 days (mean 76.9). Eight of them were admitted with the first
episode of anorexia and jaundice for 4-60 days (mean 14.3) after taking 20-40 mg/day (2-4 tablets)
of Barakol. There was no relationship between degree of symptom and dosage/duration of Barakol
intake. Three asymptomatic cases were detected with increased aminotransferase from a routine check-
up, including an 81 year old female who took half of the dosage for 120 days. The last one was a male
patient who presented with low-grade fever and nausea and vomiting. All patients had neither a history
of chronic liver disease nor known hepatotoxic substance ingestion. On admission, the mean total
bilirubin was 5.7 mg/dl and liver function test (LFf) revealed moderate to severe hepatitis (Aspatate
amino transferase (AST) range 111-1,473 U/L: mean= 692). None of them had detected viral markers.
Liver biopsy was done in 3 cases and the histopathological findings were compatible with interface
hepatitis. Two non-biopsy cases developed recurrent transaminitis after one-week re-challenging
without informing the physician. Their symptoms and LFf completely improved within 2-20 weeks
(mean 5.9) after Barakol abstinence.
Key word : Barakol, Hepatitis
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