Document Detail


Anaphylactic reaction to a dietary supplement containing willow bark.
MedLine Citation:
PMID:  12773073     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report a case of anaphylaxis resulting from the use of a willow bark-containing dietary supplement in a patient with a history of an aspirin allergy. CASE SUMMARY: A 25-year-old white woman presented to the emergency department of a community teaching hospital with anaphylaxis requiring epinephrine, diphenhydramine, methylprednisolone, and volume resuscitation to which she responded favorably. Medication history revealed that she had ingested 2 capsules of Stacker 2 (NVE Pharmaceuticals, Newton, NJ), a dietary supplement promoted for weight loss, prior to experiencing her initial symptoms. Among other active ingredients, this product contains willow bark. Of significance is that this patient also reported a history of allergy to acetylsalicylic acid. No other causes for anaphylaxis were identified. She continued to receive routine supportive care and the remaining hospital course was uncomplicated. DISCUSSION: Dietary supplements, including herbal products, are used by many individuals who consider them to be inherently safe despite limited regulatory oversight by the Food and Drug Administration. While there may be value to specific botanical ingredients, a potential for adverse effects also exists. The popular product consumed by our patient is used for weight loss and contains willow bark, a source of salicylates. Based on the Naranjo probability scale, it is probable that this case of anaphylaxis was due to this dietary supplement. CONCLUSIONS: The use of any willow bark-containing dietary supplement may present a risk of anaphylactic reaction to patients with a history of allergy to salicylates. Clinicians need to recognize the potential for adverse effects from dietary supplements.
Authors:
Joseph I Boullata; Patrick J McDonnell; Cynthia D Oliva
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  37     ISSN:  1060-0280     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-05-29     Completed Date:  2003-08-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  832-5     Citation Subset:  IM    
Affiliation:
School of Pharmacy, Temple University Health Sciences Center, Philadelphia, PA 19140-5101, USA. joseph.boullata@temple.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Anaphylaxis / chemically induced*,  therapy
Dietary Supplements / adverse effects*
Female
Humans
Plant Bark
Plant Extracts / adverse effects
Salix / adverse effects*
Chemical
Reg. No./Substance:
0/Plant Extracts

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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