Traditional Chinese Medicine and herbal hepatotoxicity: a tabular compilation of reported cases.

Traditional Chinese Medicine (TCM) with its focus on herbal use became popular worldwide. Treatment was perceived as safe, with neglect of rare adverse reactions including liver injury. To compile worldwide cases of liver injury by herbal TCM, we undertook a selective literature search in the PubMed database and searched for the items Traditional Chinese Medicine, TCM, Traditional Asian Medicine, and Traditional Oriental Medicine, also combined with the terms herbal hepatotoxicity or herb induced liver injury.

Herbal hepatotoxicity: analysis of cases with initially reported positive re-exposure tests.

Background: Positive re-exposure tests are diagnostic hallmarks for hepatotoxicity.

Objective: To test validity of positive re-exposures in herb induced liver injury.

Methods: We searched Medline database for cases of herb induced liver injury with positive re-exposures and analysed 34 cases for positive re-exposure test criteria of baseline alanine aminotransferase< 5N before re-exposure, and re-exposure alanine aminotransferase ≥ 2× baseline alanine aminotransferase.

Suspected black cohosh hepatotoxicity--challenges and pitfalls of causality assessment.

Objectives: Black cohosh (BC) is a herbal drug or herbal dietary supplement used for treatment of menopausal symptoms. Recently, however, reports have appeared about the occurrence of rare toxic liver disease in an assumed relationship with the use of BC.

Methods: We have analyzed and reviewed the data of all 69 reported cases with suspected BC hepatotoxicity.

Kava hepatotoxicity: comparison of aqueous, ethanolic, acetonic kava extracts and kava-herbs mixtures.

Ethnopharmacological Relevance: Ethanolic and acetonic kava extracts have previously been causally related to rare hepatotoxicity observed in patients from Germany and Switzerland, but causality assessment was not performed in cases of patients having taken the traditional aqueous kava extracts of South Pacific islands or kava-herbs mixtures.

Aim Of The Study: To study the possible hepatotoxicity of aqueous kava extracts of the South Pacific Islands.

Materials And Methods: Causality of hepatotoxicity by aqueous kava extracts and kava-herbs mixtures was assessed, using the updated score of the quantitative CIOMS (Council for the International Organizations of Medical Sciences).