N‐Nitroso‐Fenfluramine Hepatotoxicity Resembling Chronic Hepatitis

Kanda, Tatsuo; Yokosuka, Osamu; Tada, Motohisa; Kurihara, Tomoko; Yoshida, Soichi; Suzuki, Yutaka; Nagao, Keiichi; Saisho, Hiromitsu

doi:10.1046/j.1440-1746.2003.03074.x

Cited by 29 publications

(14 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The Chinese propriety medicine contained 12 herbal items, two of which, Heshouwu and Juemingzi, listed in Table 1 contain anthraquinones (approximately 1% by weight) are known to be hepatotoxic on prolonged intake 14–17 . In addition, with further laboratory analysis, the prescribed TCM formula is found to be adulterated with N‐nitrosofenfluramine which is highly hepatotoxic 18, 19 . The patient recovered well after the liver transplantation.…”

Section: Resultsmentioning

confidence: 99%

Traditional Chinese medicine causing hepatotoxicity in patients with chronic hepatitis B infection: a 1‐year prospective study

Yuen¹,

Tam

Fung³

et al. 2006

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

Traditional Chinese medicine causing hepatotoxicity in patients with chronic hepatitis B infection: a 1‐year prospective study

Yuen¹,

Tam

Fung³

et al. 2006

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…Assumed causality was mostly based on clinical judgment, rarely on the results of liver specific causality assessment methods [70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135…”

Section: Tcm Herbs With Published Claims Of Hepatotoxic Potentialmentioning

confidence: 99%

“…Chemical analysis of the Chase product showed lack of fenfluramine and heavy metals such as copper, lead, bismuth, cadmium, stibium, stanum, mercury, and chromium, but N -nitroso-fenfluramine was found. N -nitroso-fenfluramine was considered as possible but not yet proven to be a hepatotoxin [93], similar to other cases of liver injury due to various other slimming aids in the United Kingdom [94], Hong Kong [95], and Japan [96], including the TCM herbal product of Onshido [93]. An additional 21 Chaso-induced cases of liver injury were reported to the regulatory agency in Japan and not further analyzed [93].…”

Section: Narratives Of Tcm Hili Casesmentioning

confidence: 99%

Traditional Chinese Medicine (TCM) and Herbal Hepatotoxicity: RUCAM and the Role of Novel Diagnostic Biomarkers Such as MicroRNAs

et al. 2016

View full text Add to dashboard Cite

Background: Traditional Chinese Medicine (TCM) with its focus on herbal use is popular and appreciated worldwide with increased tendency, although its therapeutic efficacy is poorly established for most herbal TCM products. Treatment was perceived as fairly safe but discussions emerged more recently as to whether herb induced liver injury (HILI) from herbal TCM is a major issue; Methods: To analyze clinical and case characteristics of HILI caused by herbal TCM, we undertook a selective literature search in the PubMed database with the search items Traditional Chinese Medicine, TCM, alone and combined with the terms herbal hepatotoxicity or herb induced liver injury; Results: HILI caused by herbal TCM is rare and similarly to drugs can be caused by an unpredictable idiosyncratic or a predictable intrinsic reaction. Clinical features of liver injury from herbal TCM products are variable, and specific diagnostic biomarkers such as microsomal epoxide hydrolase, pyrrole-protein adducts, metabolomics, and microRNAs are available for only a few TCM herbs. The diagnosis is ascertained if alternative causes are validly excluded and causality levels of probable or highly probable are achieved applying the liver specific RUCAM (Roussel Uclaf Causality Assessment Method) as the most commonly used diagnostic tool worldwide. Case evaluation may be confounded by inappropriate or lacking causality assessment, poor herbal product quality, insufficiently documented cases, and failing to exclude alternative causes such as infections by hepatotropic viruses including hepatitis E virus infections; Conclusion: Suspected cases of liver injury from herbal TCM represent major challenges that deserve special clinical and regulatory attention to improve the quality of case evaluations and ascertain patients’ safety and benefit.

show abstract

“…‘Onshidou‐Genbi‐Kounou’, another herbal marketed for weight loss, seemed the likely cause of chronic hepatitis in a 52‐year‐old Japanese woman who took this preparation for 2 months (80). Serum levels of liver enzymes were elevated to >1500 IU/l and ANA were positive with 1:160.…”

Section: Specific Dietary Supplements Associated With Liver Injurymentioning

confidence: 99%

Review of liver injury associated with dietary supplements

Stickel

Kessebohm

Weimann

et al. 2011

Liver International

101

View full text Add to dashboard Cite

Dietary supplements (DS) are easily available and increasingly used, and adverse hepatic reactions have been reported following their intake. To critically review the literature on liver injury because of DSs, delineating patterns and mechanisms of injury and to increase the awareness towards this cause of acute and chronic liver damage. Studies and case reports on liver injury specifically because of DSs published between

show abstract

N‐Nitroso‐Fenfluramine Hepatotoxicity Resembling Chronic Hepatitis

Cited by 29 publications

References 4 publications

Traditional Chinese medicine causing hepatotoxicity in patients with chronic hepatitis B infection: a 1‐year prospective study

Traditional Chinese medicine causing hepatotoxicity in patients with chronic hepatitis B infection: a 1‐year prospective study

Traditional Chinese Medicine (TCM) and Herbal Hepatotoxicity: RUCAM and the Role of Novel Diagnostic Biomarkers Such as MicroRNAs

Review of liver injury associated with dietary supplements

Contact Info

Product

Resources

About