• Hongmin Chu, Chanran Park, Cheolhyun Kim, Kang-Keyng Sung, and Sangkwan Lee.
• Department of Internal Medicine and Neuroscience, College of Korean Medicine, Wonkwang University, Iksan, Jeonbuk.
• Medicine (Baltimore). 2018 Dec 1; 97 (51): e13577.

RationaleInjinoryung-San-Gagambang (IJORS) effectively improves hepatic dysfunction caused by polypharmacy in stroke patients.Patient ConcernsWe present 3 cases of hepatic dysfunction caused by polypharmacy, one of which was a 51-year-old man with cerebellum infarction and pneumonia as a complication of stroke. He took multiple medications because of baseline diseases. After recurrence of pneumonia, his laboratory tests showed abnormal aminotransferase levels. Another patient was an 81-year-old woman with cerebral infarction at the right-middle cerebral artery. She was also taking >5 medications. Her laboratory tests conducted on admission showed abnormally elevated aminotransferase levels. The last patient was 77-year-old man with cerebral infarction at the left-middle cerebral artery. He also had an abdominal aneurysm, a thoracic aortic aneurysm, and a myocardial infarction. After taking multiple medications including healthy functional foods, his laboratory tests showed abnormally elevated aminotransferase levels.DiagnosisDiagnosis is conducted with the result of laboratory test including blood count, chemistry test.InterventionsAll 3 patients received the same herbal treatment (IJORS decoction) for 1 to 3 weeks.OutcomesAll 3 patients' abnormal serum aminotransferase level were significantly improved by IJORS decoction treatment while keeping other medicines.LessonsIJORS can be considered as an effective treatment for hepatic dysfunction induced by numerous medications in stroke patients.

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