Liver Injury Induced by Herbal Extracts Containing Mistletoe and Kudzu

Abstract

This case of liver injury characterized by a significant increase in AST and ALT levels was related to the use of mistletoe and kudzu extracts.

Systematic Review on Chinese Herbal Medicine Induced Liver Injury

“…114 cases were included in total, of which 83 cases were from China, 26 were from Korea, 4 were from the United States, and 1 was from Japan. Detailed information of CHM, like locality and specific taxa, was not mentioned in all 17 articles, and only 4 of 17 described correct scientific names of herbs [ 18 , 19 , 21 , 22 ]. Among six articles reporting liver injury attributed to Chinese patent drugs [ 15 – 17 , 21 , 23 , 29 ], there was one [ 29 ] without detailed herbal ingredients, six without herbal contents, three [ 15 , 23 , 29 ] without recommended dosage and usage, and three [ 16 , 23 , 29 ] without brand names or manufacturers.…”

“…Of the total 17 articles included, 7 directly used the RUCAM scale to assess causality, while the other 10 articles provided associated information, based on which RUCAM can be performed. Four articles [ 9 , 25 , 28 , 31 ] explicitly excluded HEV by serology tests, and four [ 20 , 22 , 26 , 30 ] demonstrated exclusion of viral hepatitis without specific mention of HEV. Fifty-six cases of one article [ 29 ], scored no less than 3 points, were not supplied with detailed information and cannot be graded by RUCAM.…”