Abstract: Objective To analyze the relationship between Senecio scandens and drug induced liver injury, so as to provide reference for clinical safe drug use. Methods A case of hepatic sinusoidal obstruction syndrome after taking suspected senecio herb was reported. The chromatograms of the standard senecilline, which is one kind of Pyrrolizidine Alkaloids, with the patient’s blood and urine samples were compared, and the correlation between the suspected drug and liver injury was assessed according to the Roussel Uclaf Causality Assessment Method(RUCAM) and guidelines for clinical diagnosis and treatment of herb-induced liver injury. Results The patient’s liver injury was manifested as hepatic sinusoidal obstruction syndrome. The patient’s urine sample propably contained the analogues or metabolites of senecilline. The RUCAM scale score was eight points, judging that there was a correlation between suspected herbal medicine and liver injury. Conclusion When taking traditional Chinese medicine, carefully evaluate whether there are Senecio scandens. If liver injury occurs, the drug should be discontinued promptly and targeted investigations and treatment should be carried out.

Key words: Senecio scandens, pyrrolizidine alkaloids, hepatic sinusoidal obstruction syndrome, drug induced liver injury, RUCAM, adverse drug reaction