Toxic acute hepatitis and hepatic fibrosis after consumption of chaparral tablets
In this report we describe a young, previously healthy woman who developed severe acute hepatitis after consumption of chaparral tablets, a commonly used herbal product. In this case, the elimination-rechallenge event and the exclusion of other possible aetiologic factors strongly supported true causality between the herbal product and the liver damage. Primary liver biopsy showed severe toxic hepatitis consistent with previous reports of chaparral-induced liver damage. Later, 6 months after the liver function tests had normalized, permanent hepatic fibrosis could still be seen.
Available from: Jorge Reyes Esparza
- "In low and high doses it inhibits lipoxygenase pathways. One hypothesis is that high concentrations of NGGA inhibit cyclo-oxygenase leading to the production of proinflammatory mediators that produce hepatotoxicity (Kauma et al., 2004). "
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ABSTRACT: In Mexico, local empirical knowledge about medicinal properties of plants is the basis for their use as home remedies. It is generally accepted by many people in Mexico and elsewhere in the world that beneficial medicinal effects can be obtained by ingesting plant products. In this review, we focus on the potential pharmacologic bases for herbal plant efficacy, but we also raise concerns about the safety of these agents, which have not been fully assessed. Although numerous randomized clinical trials of herbal medicines have been published and systematic reviews and meta-analyses of these studies are available, generalizations about the efficacy and safety of herbal medicines are clearly not possible. Recent publications have also highlighted the unintended consequences of herbal product use, including morbidity and mortality. It has been found that many phytochemicals have pharmacokinetic or pharmacodynamic interactions with drugs. The present review is limited to some herbal medicines that are native or cultivated in Mexico and that have significant use. We discuss the cultural uses, phytochemistry, pharmacological, and toxicological properties of the following plant species: nopal (Opuntia ficus), peppermint (Mentha piperita), chaparral (Larrea divaricata), dandlion (Taraxacum officinale), mullein (Verbascum densiflorum), chamomile (Matricaria recutita), nettle or stinging nettle (Urtica dioica), passionflower (Passiflora incarnata), linden flower (Tilia europea), and aloe (Aloe vera). We conclude that our knowledge of the therapeutic benefits and risks of some herbal medicines used in Mexico is still limited and efforts to elucidate them should be intensified.
Toxicology and Applied Pharmacology 03/2008; 227(1):125-35. DOI:10.1016/j.taap.2007.10.005 · 3.71 Impact Factor
Available from: Eleonora Patsenker
Journal of Hepatology 12/2005; 43(5):901-10. DOI:10.1016/j.jhep.2005.08.002 · 11.34 Impact Factor
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ABSTRACT: A significant number of herbal products have been associated with hepatotoxicity. Attribution of liver injury to a specific herbal pro-duct may be difficult. There are few clinical or laboratory manifestations that specifically suggest that liver injury is the result of aspecific herbal. Compounding this difficulty is that the patient may have liver disease from another cause, may be consuming other potentially hepatotoxic products, or may be using a contaminated herbal product. The most important clue often is the temporal relationship between initiation of the herbal product and the appearance of liver injury; of equal importance is the resolution of the injury following withdrawal of the herbal product.
Clinics in Laboratory Medicine 04/2006; 26(1):227-41, x. DOI:10.1016/j.cll.2006.02.005 · 1.37 Impact Factor
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