Case series and review of Ayurvedic medication induced liver injury

BMC Complementary Medicine and Therapies

David R. Braxton¹  Justin K. Lee¹  Tse-Ling Fong²  Christopher M. Karousatos³ 

[1] Hoag Memorial Hospital Presbyterian, Newport Beach, CA, USA;Hoag Memorial Hospital Presbyterian, Newport Beach, CA, USA;Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, 2/F, 90033, Los Angeles, CA, USA;Keck School of Medicine, University of Southern California, Los Angeles, CA, USA;

关键词: Ayurveda;    Ayurvedic medicine;    Drug induced liver injury (DILI);    Herb induced liver injury (HILI);    Traditional Chinese medicine;    Roussel Uclaf causality assessment method;   

DOI  :  10.1186/s12906-021-03251-z

来源: Springer

【 摘 要 】

BackgroundComplementary and alternative medicine use among Americans is prevalent. Originating in India, Ayurvedic medicine use in the United States has grown 57% since 2002. CAM accounts for a significant proportion of drug induced liver injury in India and China, but there have been only three reports of drug induced liver injury from Ayurvedic medications in the U.S. We report three cases of suspected Ayurvedic medication associated liver injury seen at a Southern California community hospital and review literature of Ayurvedic medication induced liver injury.Case presentationsThree patients presented with acute hepatocellular injury and jaundice after taking Ayurvedic supplements for 90–120 days. First patient took Giloy Kwath consisting solely of Tinospora cordifolia. Second patient took Manjishthadi Kwatham and Aragwadhi Kwatham, which contained 52 and 10 individual plant extracts, respectively. Third patient took Kanchnar Guggulu, containing 10 individual plant extracts. Aminotransferase activities decreased 50% in < 30 days and all 3 patients made a full recovery. Roussel Uclaf Causality Assessment Method (RUCAM) scores were 7–8, indicating probable causality. These products all contained ingredients in other Ayurvedic and traditional Chinese medicines with previously reported associations with drug induced liver injury.ConclusionsThese patients highlight the risk of drug induced liver injury from Ayurvedic medications and the complexity of determining causality. There is a need for a platform like LiverTox.gov to catalog Ayurvedic ingredients causing liver damage.

【 授权许可】

CC BY