A Case of Acute Cholestatic Hepatitis Associated with the Seeds ofPsoralea corylifolia(Boh-Gol-Zhee)

Abstract

The potential hepatotoxicity of herbal remedies is usually ignored in daily life. One such compound, Boh-Gol-Zhee (in Chinese, Bu Ku Zi), appeared to be associated with the occurrence of acute cholestatic hepatic injury in the following case. Some alternative medicine therapists claim that Psoralea corylifolia is effective for the treatment of osteoporosis. We observed a case of acute cholestatic hepatitis associated with the use of the seeds of Psoralea corylifolia in amounts over 10 times the usual dose in a postmenopausal woman. Liver biopsy showed zone three necroses, degenerating cells, cholestasis, and infiltrations with inflammatory cells. This case stresses the need to warn of the potential hepatotoxicity of the seed of Psoralea corylifolia, especially in a large dose.

Evaluation of hepatotoxicity and cholestasis in rats treated with EtOH extract of Fructus Psoraleae

“…In addition, sexual dimorphism in hepatotoxicity of rats is also attributed to sex-specific sensitivity, resulting from variations between the sexes in factors including body weight, plasma volume, gastric emptying time, plasma protein levels, CYP activity, drug transporter function and clearance activity (Agrawal and Shapiro, 2003;Kadiri and Ajayi, 2000;Ohhira et al, 2006). Moreover, FP-induced adverse effects related to hepatotoxicity mainly happened on female patients (Cheung et al, 2009;Nam et al, 2005). In addition, sex-related differences in the effects of synthetic formed psoralens such as 5-methoxypsoralen, or 8-methoxypsoralen in C57 mice have been found before (Diawara et al, 2000).…”

“…Also, some scientists find hepatotoxicity in C57 mice induced by psoralens whose synthetic forms are 5-methoxypsoralen (bergapten), or 8-methoxypsoralen (xanthotoxin) (Chitturi and Farrell, 2008). What's more, there were some previous clinical reports of hepatitis associated with the use of FP (Cheung et al, 2009;Nam et al, 2005). Some researchers demonstrate that Zhuangguguanjie Wan, a traditional Chinese compound prescription, whose main components include FP, have side-effects related to liver damage (Cheng and Cai, 2000).…”

Liver injury associated with the use ofFructus Psoraleae(Bol-gol-zhee or Bu-gu-zhi) and its related proprietary medicine

“…5 In animal studies in China of oral FP 0.4 g versus 1.6 g daily for 12 weeks in rats, liver injury by FP was in the form of steatosis and hepatocytes necrosis in the high-dose group. 10 The mechanisms of FP-related liver injury are not well understood.…”

“…4 However, there was only one case report of hepatitis associated with the use of FP in Korea previously. 5 Here we report three further cases of acute liver injury after exposure to FP and its related proprietary medicine.…”

Bavachin Induces Apoptosis through Mitochondrial Regulated ER Stress Pathway in HepG2 Cells

“…1,2) In recent years, increasing clinical reports have indicated potential hepatotoxicity of FP in patients, [3][4][5] for instance, Cheung et al showed three cases of acute hepatitis after exposed to FP and its related medicine such as Bu-gu-zhi intramuscular injection, 3) and concerns grow over the health effects of FP. However, the hepatotoxic components and the mechanism of FP-induced hepatotoxicity are not fully understood.…”