Article

Hepatitis induced by Noni juice from Morinda citrifolia: a rare cause of hepatotoxicity or the tip of the iceberg?

Department of Internal Medicine II, Ludwig Maximilians University of Munich, Germany.
Digestion (Impact Factor: 2.03). 02/2006; 73(2-3):167-70. DOI: 10.1159/000094524
Source: PubMed

ABSTRACT A 24-year-old female patient presented to her community hospital with mild elevations of serum transaminase and bilirubin levels. Because of multiple sclerosis, she was treated with interferon beta-1a for 6 weeks. After exclusion of viral hepatitis due to hepatitis A-E, interferon beta-1a was withdrawn under the suspicion of drug-induced hepatitis. One week later, she was admitted again to her community hospital with severe icterus. The transaminase and bilirubin levels were highly elevated, and a beginning impairment of the liver synthesis was expressed by a reduced prothrombin time. The confinement to our department occurred with a fulminant hepatitis and the suspicion of beginning acute liver failure. There was no evidence for hepatitis due to potentially hepatotoxic viruses, alcoholic hepatitis, Budd-Chiari syndrome, hemochromatosis, and Wilson's disease. In her serum there were high titers of liver-kidney microsomal type 1 autoantibody; the serum gamma globulin levels were in the normal range. Fine-needle aspiration biopsy of the liver ruled out an autoimmune hepatitis but showed signs of drug-induced toxicity. During the interview, she admitted that for 'general immune system stimulation' she had been drinking Noni juice, a Polynesian herbal remedy made from a tropical fruit (Morinda citrifolia), during the past 4 weeks. After cessation of the Noni juice ingestion, her transaminase levels normalized quickly and were in the normal range within 1 month.

Full-text

Available from: Alex L Gerbes, Mar 31, 2015
2 Bookmarks
 · 
383 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The prevalence of diabetes is on a steady increase worldwide and it is now identified as one of the main threats to human health in the 21(st) century. In Nigeria, the use of herbal medicine alone or alongside prescription drugs for its management is quite common. We hereby carry out a review of medicinal plants traditionally used for diabetes management in Nigeria. Based on the available evidence on the species' pharmacology and safety, we highlight ways in which their therapeutic potential can be properly harnessed for possible integration into the country's healthcare system.
    Journal of Ethnopharmacology 06/2014; 155(2). DOI:10.1016/j.jep.2014.05.055 · 2.94 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The miracle medicinal plant Morinda citrifolia L., also called as Noni, Great Morinda or Indian mulberry, belongs to the family Rubiaceae. Its fruit has been used traditionally for more than 2000 years by native Polynesians. However, all parts of the plant have medicinal properties. More than 160 phytochemicals have been isolated from the plant Noni, which makes it an amazing herbal remedy for the treatment of numerous disorders including cancer. Recently, the Noni juice has been in high demand in market as complementary and alternative medicine (CAM) for its multi-dimensional health benefits. It is a potent antibacterial, antiviral, antifungal, antihelminthic, anticancer, analgesic, anti-inflammatory, anti-oxidant, hypotensive, cardiovascular protective, wound healer, anxiolytic, sedative, antigout, antiobesity and immune enhancing agent. Anticancerous activity of Morinda citrifolia is attributable to its anti-inflammatory, antioxidant and apoptosis-inducing effects. Based on toxicological and mutagenicity assessment, Noni juice has been considered as safe. Few reports of hepatotoxicity exist, although there are many evidences suggesting hepatoprotective effects of Noni. Even though large number of in vitro studies has been carried out but only few clinical trials exist in the literature to suggest real beneficial effects of Noni in humans. Recently, Noni fruit juice has been accepted as a novel food element in the European Union. A number of scientific studies have been conducted to elucidate the mechanism of action of phytoconstituents of Noni. In this review, active phytochemical constituents, pharmacological properties, mechanism of action, and various immunomodulatory and therapeutic potentials of Noni usage as a useful herbal medicine are discussed in detail, which could be very helpful in safeguarding health of humans and their companion animals. A special focus has been made on the potent utility of this wonderful herbal plant in preventing and treating the deadly malady of cancer.
    International Journal of Pharmacology 05/2014; 9(8):462-492.. DOI:10.3923/ijp.2013.462.492 · 0.98 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We encountered a case of hypercobalaminemia induced by oral intake of an energy drink after total gastrectomy. The patient was referred to our hospital due to findings suspicious for gastric cancer on screening. A 20 mm type 0-IIc lesion was detected in the gastric subcardia on esophagogastroduodenoscopy. Total gastrectomy followed by Roux-en-Y reconstruction was performed. He was discharged without complications. His basal serum vitamin B12 level was initially maintained with monthly intramuscular injections of vitamin B12. After 9 months, his serum vitamin B12 level suddenly increased up to 36-fold higher than the normal range and persisted there for one year without vitamin B12 injections. The patient ultimately reported consuming half a bottle of an energy drink each day during this time period. This case demonstrates the risk of unexpected hypervitaminemia resulting from self-administration of nutritional supplements.
    Journal of Rural Medicine 01/2013; 8(1):181-5. DOI:10.2185/jrm.8.181