 |
|
Chaparral-Associated Hepatotoxicity
Nasreen M. Sheikh, MD;
Rossanne M. Philen, MD, MS;
Lori A. Love, MD, PhD
Arch Intern Med. 1997;157(8):913-919.
Abstract
| |
Background
Personal health care practices that may include the use of dietary supplements are common in the United States. Products marketed as dietary supplements are diverse and may include botanicals, vitamins, and/or minerals. Chaparral (Larrea tridentata) is a botanical dietary supplement made from a desert shrub and used for its antioxidant properties. Several reports of chaparral-associated hepatitis have been published since 1990, but a complete picture of the clinical presentation is still unclear.
Materials and Methods
We reviewed the 18 case reports of adverse events associated with the ingestion of chaparral reported to the Food and Drug Administration between 1992 and 1994. These reports were from health care professionals, state health departments, and individual consumers.
Results
Of 18 reports of illnesses associated with the ingestion of chaparral, there was evidence of hepatotoxicity in 13 cases. Clinical presentation, characterized as jaundice with a marked increase in serum liver chemistry values occurred 3 to 52 weeks after the ingestion of chaparral, and it resolved 1 to 17 weeks after most individuals stopped their intake of chaparral. The predominant pattern of liver injury was characterized as toxic or drug-induced cholestatic hepatitis; in 4 individuals, there was progression to cirrhosis; and in 2 individuals, there was acute fulminant liver failure that required liver transplants.
Conclusions
These data indicate that the use of chaparral may be associated with acute to chronic irreversible liver damage with fulminant hepatic failure, and they underscore the potential for certain dietary supplement ingredients to cause toxic effects on the liver. Health professionals should be encouraged to inquire routinely about the use of dietary supplements and other products, to be alert to potential adverse effects that may be associated with these products, and, finally, to report any serious adverse events associated with these products through the MEDWatch Program of the Food and Drug Administration.
Arch Intern Med. 1997;157:913-919
Author Affiliations
From the Clinical Research and Review Staff, Office of Special Nutritionals, Center for Food Safety and Applied Nutrition, Food and Drug Administration, Washington, DC (Drs Sheikh and Love), and the Health Studies Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Ga (Dr Philen).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Nordihydroguaiaretic Acid from Creosote Bush (Larrea tridentata) Mitigates 12-O-Tetradecanoylphorbol-13-Acetate-induced Inflammatory and Oxidative Stress Responses of Tumor Promotion Cascade in Mouse Skin
Rahman et al.
Evid Based Complement Alternat Med 2009;0:nep076v1-nep076.
ABSTRACT
| FULL TEXT
Acute liver injury associated with the use of herbal preparations containing glucosamine: three case studies
Smith and Dillon
BMJ Case Reports 2009;2009:bcr0220091603-bcr0220091603.
ABSTRACT
| FULL TEXT
Application of FDA Adverse Event Report Data to the Surveillance of Dietary Botanical Supplements
Wallace et al.
The Annals of Pharmacotherapy 2008;42:653-660.
ABSTRACT
| FULL TEXT
The Use of Selected Nutrition Supplements and Complementary and Alternative Medicine in Liver Disease
Hanje et al.
Nutr Clin Pract 2006;21:255-272.
ABSTRACT
| FULL TEXT
Students Investigating the Antiproliferative Effects of Synthesized Drugs on Mouse Mammary Tumor Cells
Hammamieh et al.
cellbioed 2005;4:221-234.
ABSTRACT
| FULL TEXT
Herbal Product Contamination and Toxicity
Smolinske
Journal of Pharmacy Practice 2005;18:188-208.
ABSTRACT
Hepatic Injury in 12 Patients Taking the Herbal Weight Loss Aids Chaso or Onshido
Adachi et al.
ANN INTERN MED 2003;139:488-492.
ABSTRACT
| FULL TEXT
High Prevalence of Potentially Hepatotoxic Herbal Supplement Use in Patients With Fulminant Hepatic Failure
Estes et al.
Arch Surg 2003;138:852-858.
ABSTRACT
| FULL TEXT
An approach for integrating complementary- alternative medicine into primary care
Frenkel and Borkan
Fam Pract 2003;20:324-332.
ABSTRACT
| FULL TEXT
Potential Physician Malpractice Liability Associated with Complementary and Integrative Medical Therapies
Cohen and Eisenberg
ANN INTERN MED 2002;136:596-603.
ABSTRACT
| FULL TEXT
Drug points: Hepatitis associated with Kava, a herbal remedy for anxiety
Escher et al.
BMJ 2001;322:139-139.
FULL TEXT
Alternatives to the Use of Estrogen in Postmenopausal Women
Pinkerton and Santen
Endocr. Rev. 1999;20:308-320.
ABSTRACT
| FULL TEXT
The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines
Marty
JAMA 1999;281:1852-1853.
FULL TEXT
|
