RT Journal Article
SR Electronic
T1 Herbal tea induced hepatic veno-occlusive disease: quantification of toxic alkaloid exposure in adults.
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 101
OP 104
DO 10.1136/gut.26.1.101
VO 26
IS 1
A1 C R Kumana
A1 M Ng
A1 H J Lin
A1 W Ko
A1 P C Wu
A1 D Todd
YR 1985
UL http://gut.bmj.com/content/26/1/101.abstract
AB Four young Chinese women took daily doses of an unidentified 'Indian' herbal tea as treatment for psoriasis. Three (one of whom died), developed ascites, hepatomegaly and biochemical abnormalities within 19-45 days. The fourth patient discontinued herbal tea after 21 days when she developed a skin rash. Two patients had portal hypertension, while all had liver histology showing features of veno-occlusive disease. Pyrrolizidine alkaloids were identified spectrophotometrically in the brewed tea, and in the chopped leaves of the herbal mixture; the mean dose in the tea prepared for consumption being 12 mg/day of alkaloid base and 18 mg/day of N-oxide. The mean cumulative dose of alkaloids (base + N-oxide) before onset of symptoms (three patients), was estimated to be 18 mg/kg. In the asymptomatic patient with histological liver disease only, the corresponding dose was 15 mg/kg. These cases thus provide some measure of pyrrolizidine alkaloid toxicity in adults.