Herbal and Dietary Supplement–Induced Liver Injury

Boer, Ynto S. de; Sherker, Averell H.

doi:10.1016/j.cld.2016.08.010

Cited by 63 publications

(53 citation statements)

References 74 publications

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“…In the present study, 26 people recovered within 1 year. Compared with Western countries, the abuse of herbal products existed in China and other Asian countries . In the present research, herbal products made up over half of the whole implicated drugs, as well as in chronic DILI.…”

Section: Discussionmentioning

confidence: 61%

“…Compared with Western countries, the abuse of herbal products existed in China and other Asian countries. 13,18,[22][23][24][25] In the present research, herbal products made up over half of the whole implicated drugs, as well as in chronic DILI. A previous report from a Spanish registry showed that cardiovascular drugs and central nervous system drugs were likely to cause chronic DILI, the commonest insulting chemical components were amoxicillin/clavulanate, bentazepam, atorvastatin, and captopril.…”

Section: Discussionmentioning

confidence: 67%

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Prolonged interval of total bilirubin decline is an early independent predictive factor of chronic persistent drug‐induced liver injury

Zhu

Wang

Zhao

et al. 2019

Hepatology Research

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Aim Chronic drug‐induced liver injury (DILI) with persistent abnormal liver function tests (LFTs) >6 months after cessation of the insulting drugs could progress to cirrhosis. The aim of the present study was to identify the risk factors of chronic DILI for early recognition and better management. Methods History of drug intake and results of LFTs were retrospectively retrieved for patients with a discharge diagnosis of DILI for at least 1‐year follow up. The risk factors independently associated with chronic DILI were analyzed by multiple logistic regression analyses. Results A total of 33 of the 140 DILI patients had persistent abnormal LFTs >6 months, which were considered as chronic DILI. It was found that the time intervals of alanine aminotransferase and total bilirubin decline from the peak to their half peak (T0.5ALT, T0.5TBIL) were significantly longer in the chronic DILI group than that in the recovered group (P = 0.001 and P < 0.001). The risk factors associated with chronic DILI independently were T0.5TBIL (OR 1.315, 95% CI 1.038–1.668), longer period of insulting drug(s) intake (OR 1.018, 95% CI 1.003–1.033), mixed/cholestatic pattern (OR 97.159, 95% CI 1.866–5005.994). More importantly, receiver operating characteristic curve analysis showed that the prognostic value of T0.5TBIL for chronic DILI had a sensitivity of 60.0% at a specificity of 90.7% with the threshold of 16 days. Conclusions The time intervals of total bilirubin decline from its peak to half of its peak (T0.5TBIL) was an early independent predictive factor of chronic DILI, suggesting that T0.5TBIL might serve as an indicator for chronicity.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 67%

Prolonged interval of total bilirubin decline is an early independent predictive factor of chronic persistent drug‐induced liver injury

Zhu

Wang

Zhao

et al. 2019

Hepatology Research

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“…Recent studies from the USA and Europe have revealed that middle‐aged women are more likely to be affected by herbal and dietary supplement (HDS)‐induced liver injury. A significant proportion of them have a hepatocellular injury pattern (R > 5) with jaundice and greater disease severity . BGZ is a HDS and, until now, 37 cases of BGZILI have been reported, mainly in the Chinese literature .…”

Section: Discussionmentioning

confidence: 99%

“…However, the duration of hospitalization was significantly longer in the severe group. (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) .343…”

Section: Comparison Of Clinical and Biochemical Features For Differmentioning

confidence: 99%

Clinicopathological features of Bu Gu Zhi‐induced liver injury, a long‐term follow‐up cohort study

Wang

Wee

Soon

et al. 2019

Liver International

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Background & Aims Bu Gu Zhi (BGZ) is a Chinese herb consumed mainly for osteoporosis treatment. Only small case series of BGZ‐induced liver injury (BGZILI) have been reported. We describe the clinicopathological features and clinical course of BGZILI. Methods Patients diagnosed with drug‐induced liver injury (DILI) at Beijing Friendship Hospital from 2005 to 2017 were reviewed. Clinical and follow‐up data were analysed. Results Of the 547 DILI patients, 40 cases (7.3%) were attributed to BGZILI. About 34/40 (85.0%) patients were females with a median age of 63 (range, 54‐70) years. The median latency period was 45 (range, 29‐90) days. Patients commonly presented with loss of appetite (57.5%), dark urine (57.5%) and fatigue (55.0%). The median level of alanine aminotransferase and aspartate aminotransferase at BGZILI onset was 673.5 and 423.0 U/L respectively. Total bilirubin (TB) and direct bilirubin (DB) were 59.0 and 39.4 µmol/L respectively. The biochemical liver injury pattern was hepatocellular (92.5%), cholestatic (5.0%) and mixed (2.5%). They were categorized into ‘mild’ (N = 23, 57.5%), ‘moderate’ (6, 15.0%) or ‘severe’ (11, 27.5%) according to severity assessment by DILI network. The main histological injury pattern in 9/40 patients with liver biopsy was acute hepatitis with/without cholestasis. Median duration of follow‐up was 26.3 months with recovery in 37 patients within 6 months. No patients died or required transplantation. Conclusions BGZ‐induced liver injury manifested more often as a hepatocellular injury pattern with mild to moderate hepatocellular damage. Most patients recovered after cessation of BGZ within 6 months, and none developed end‐stage liver disease or died.

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“…A potential issue is that supplements may lead to unexpected adverse outcome. Liver injury, as an example, is a well‐recognized although rare complication of supplement use …”

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confidence: 99%

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Bloomgarden

2018

Journal of Diabetes

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Herbal and Dietary Supplement–Induced Liver Injury

Cited by 63 publications

References 74 publications

Prolonged interval of total bilirubin decline is an early independent predictive factor of chronic persistent drug‐induced liver injury

Prolonged interval of total bilirubin decline is an early independent predictive factor of chronic persistent drug‐induced liver injury

Clinicopathological features of Bu Gu Zhi‐induced liver injury, a long‐term follow‐up cohort study

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