Document Detail

Greater Celandine hepatotoxicity: a clinical review.
MedLine Citation:
PMID:  23109446     Owner:  NLM     Status:  MEDLINE    
Herbal hepatotoxicity is a rare and poorly described disease because reported cases are mostly scattered and lack an appropriate causality assessment. We now describe in detail the clinical picture of herbal hepatotoxicity by extracts of Greater Celandine (GC), syn. Chelidonium majus L. from the Papaveraceae family, which contain more than 20 ingredients including various biologically active isoquinoline alkaloids. For this purpose, we analyzed and reviewed published cases of 16 patients from various European countries. In all patients, herbal hepatotoxicity was of probable and highly probable causality for GC, using the original and updated scale of CIOMS (Council for International Organizations of Medical Sciences). GC associated hepatotoxicity usually has an acute clinical course exhibiting a hepatocellular pattern of injury and is correlated to an idiosyncratic reaction with its metabolic subtype. Jaundice combined with high values of serum aminotransferases was present in virtually all cases with favourable outcome despite severe clinical course. In conclusion, GC hepatotoxicity is a typical herbal hepatotoxicity with a sound causality track for GC, but there is uncertainty regarding the respective causative compound(s). The present detailed review of GC hepatotoxicity may serve as an example for clinical causality assessments of future cases of liver injury due to other herbs.
Rolf Teschke; Christian Frenzel; Xaver Glass; Johannes Schulze; Axel Eickhoff
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of hepatology     Volume:  11     ISSN:  1665-2681     ISO Abbreviation:  Ann Hepatol     Publication Date:    2012 Nov-Dec
Date Detail:
Created Date:  2012-10-30     Completed Date:  2013-04-15     Revised Date:  2013-05-16    
Medline Journal Info:
Nlm Unique ID:  101155885     Medline TA:  Ann Hepatol     Country:  Mexico    
Other Details:
Languages:  eng     Pagination:  838-48     Citation Subset:  IM    
Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Klinikum Hanau, Teaching Hospital of the Medical Faculty of the Goethe University Frankfurt/Main, Germany.
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MeSH Terms
Biological Markers / blood
Chelidonium / adverse effects*,  chemistry
Dose-Response Relationship, Drug
Drug-Induced Liver Injury / blood,  diagnosis,  etiology*,  therapy
Jaundice / chemically induced
Liver / drug effects*,  enzymology,  pathology
Middle Aged
Plant Extracts / administration & dosage,  adverse effects*
Plants, Medicinal
Risk Assessment
Risk Factors
Transaminases / blood
Reg. No./Substance:
0/Biological Markers; 0/Plant Extracts; EC 2.6.1.-/Transaminases

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

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