With growing antipathy toward conventional prescription drugs due to the fear of adverse events,the general and patient populations have been increasingly using complementary and alternative medications(CAMs)for manag...With growing antipathy toward conventional prescription drugs due to the fear of adverse events,the general and patient populations have been increasingly using complementary and alternative medications(CAMs)for managing acute and chronic diseases.The general misconception is that natural herbal-based preparations are devoid of toxicity,and hence short-and long-term use remain justified among people as well as the CAM practitioners who prescribe these medicines.In this regard,Ayurvedic herbal medications have become one of the most utilized in the East,specifically the Indian sub-continent,with increasing use in the West.Recent well-performed observational studies have confirmed the hepatotoxic potential of Ayurvedic drugs.Toxicity stems from direct effects or from indirect effects through herbal metabolites,unknown herb-herb and herbdrug interactions,adulteration of Ayurvedic drugs with other prescription medicines,and contamination due to poor manufacturing practices.In this exhaustive review,we present details on their hepatotoxic potential,discuss the mechanisms,clinical presentation,liver histology and patient outcomes of certain commonly used Ayurvedic herbs which will serve as a knowledge bank for physicians caring for liver disease patients,to support early identification and treatment of those who present with CAM-induced liver injury.展开更多
AIM:To investigate the potential role of khat in triggering auto immune hepatitis.METHODS:Patients with a history of khat use and acute hepatitis were identified using the computer database in the hepatology departmen...AIM:To investigate the potential role of khat in triggering auto immune hepatitis.METHODS:Patients with a history of khat use and acute hepatitis were identified using the computer database in the hepatology department at the Royal Hallamshire Hospital.They were then assessed for probability of having autoimmune hepatitis using the revised autoimmune hepatitis scoring criteria.RESULTS:Six patients were identified.All of them had presented with acute hepatitis on a background of khat.All were male and five of these patients were of Somali origin,while one patient was from Yemen.The patients were given points on the modified autoimmune hepatitis score which is based on their liver enzymes,autoimmune screen,exclusion of viral hepatitis alcohol and drugs,immunoglobulin levels and liver histology.The patients were given a score of-4 for khat use due to its potential to cause drug induced liver injury.Five of these patients scored between 10 and 15 points,placing them in the probable group for having autoimmune hepatitis.All of these patients were treated with prednisolone and demonstrated a good response to immunosuppression.CONCLUSION:One possibile cause of hepatotoxicity with khat could be via triggering of autoimmune hepatitis in a genetically susceptible individual.Further studies are needed for confirmation.展开更多
文摘With growing antipathy toward conventional prescription drugs due to the fear of adverse events,the general and patient populations have been increasingly using complementary and alternative medications(CAMs)for managing acute and chronic diseases.The general misconception is that natural herbal-based preparations are devoid of toxicity,and hence short-and long-term use remain justified among people as well as the CAM practitioners who prescribe these medicines.In this regard,Ayurvedic herbal medications have become one of the most utilized in the East,specifically the Indian sub-continent,with increasing use in the West.Recent well-performed observational studies have confirmed the hepatotoxic potential of Ayurvedic drugs.Toxicity stems from direct effects or from indirect effects through herbal metabolites,unknown herb-herb and herbdrug interactions,adulteration of Ayurvedic drugs with other prescription medicines,and contamination due to poor manufacturing practices.In this exhaustive review,we present details on their hepatotoxic potential,discuss the mechanisms,clinical presentation,liver histology and patient outcomes of certain commonly used Ayurvedic herbs which will serve as a knowledge bank for physicians caring for liver disease patients,to support early identification and treatment of those who present with CAM-induced liver injury.
文摘AIM:To investigate the potential role of khat in triggering auto immune hepatitis.METHODS:Patients with a history of khat use and acute hepatitis were identified using the computer database in the hepatology department at the Royal Hallamshire Hospital.They were then assessed for probability of having autoimmune hepatitis using the revised autoimmune hepatitis scoring criteria.RESULTS:Six patients were identified.All of them had presented with acute hepatitis on a background of khat.All were male and five of these patients were of Somali origin,while one patient was from Yemen.The patients were given points on the modified autoimmune hepatitis score which is based on their liver enzymes,autoimmune screen,exclusion of viral hepatitis alcohol and drugs,immunoglobulin levels and liver histology.The patients were given a score of-4 for khat use due to its potential to cause drug induced liver injury.Five of these patients scored between 10 and 15 points,placing them in the probable group for having autoimmune hepatitis.All of these patients were treated with prednisolone and demonstrated a good response to immunosuppression.CONCLUSION:One possibile cause of hepatotoxicity with khat could be via triggering of autoimmune hepatitis in a genetically susceptible individual.Further studies are needed for confirmation.
