| Herbal does not mean innocuous: ten cases of severe hepatotoxicity associated with dietary supplements from Herbalife products. | |
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MedLine Citation:
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PMID: 17692989 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND/AIMS: Herbal agents are popular and perceived as safe because they are supposedly 'natural'. We report 10 cases of toxic hepatitis implicating Herbalife products. METHODS: To determine the prevalence and outcome of hepatotoxicity due to Herbalife products. A questionnaire was sent to all public Swiss hospitals. Reported cases were subjected to causality assessment using the CIOMS criteria. RESULTS: Twelve cases of toxic hepatitis implicating Herbalife preparations (1998-2004) were retrieved, 10 sufficiently documented to permit causality analysis. Median age of patients was 51 years (range 30-69) and latency to onset was 5 months (0.5-144). Liver biopsy (7/10) showed hepatic necrosis, marked lymphocytic/eosinophilic infiltration and cholestasis in five patients. One patient with fulminant liver failure was successfully transplanted; the explant showed giant cell hepatitis. Sinusoidal obstruction syndrome was observed in one case. Three patients without liver biopsy presented with hepatocellular (2) or mixed (1) liver injury. Causality assessment of adverse drug reaction was classified as certain in two, probable in seven and possible in one case(s), respectively. CONCLUSIONS: We present a case series of toxic hepatitis implicating Herbalife products. Liver toxicity may be severe. A more detailed declaration of components and pro-active role of regulatory agencies would be desirable. |
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Authors:
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Alain M Schoepfer; Antoinette Engel; Karin Fattinger; Urs A Marbet; Dominique Criblez; Juerg Reichen; Arthur Zimmermann; Carl M Oneta |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2007-07-24 |
Journal Detail:
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Title: Journal of hepatology Volume: 47 ISSN: 0168-8278 ISO Abbreviation: J. Hepatol. Publication Date: 2007 Oct |
Date Detail:
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Created Date: 2007-09-03 Completed Date: 2007-12-06 Revised Date: 2009-11-19 |
Medline Journal Info:
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Nlm Unique ID: 8503886 Medline TA: J Hepatol Country: England |
Other Details:
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Languages: eng Pagination: 521-6 Citation Subset: IM |
Affiliation:
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University Hospital of Bern, Gastroenterology Clinic, Bern, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Dietary Supplements / adverse effects* Drug-Induced Liver Injury / diagnosis*, epidemiology*, pathology Ephedra / adverse effects Female Humans Male Middle Aged Prevalence Questionnaires Switzerland / epidemiology |
| Chemical | |
Reg. No./Substance:
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0/Herbalife |
| Comments/Corrections | |
Comment In:
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J Hepatol. 2007 Oct;47(4):444-6
[PMID:
17692988
]
J Hepatol. 2008 Aug;49(2):289-90; author reply 290-1 [PMID: 18571274 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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