Herb-Induced Liver Injury by Ayurvedic Ashwagandha as Assessed for Causality by the Updated RUCAM: An Emerging Cause
Bokan G, Glamočanin T, Mavija Z, Vidović B, Stojanović A, Björnsson ES, Vučić V
Pharmaceuticals (Basel, Switzerland) · 13 citas
Cómo se estudió
- Diseño
- Reporte de caso (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- COST Action CA17112—Prospective European Drug Induced Liver Injury Network (ProEuroDILINet)
- Gobierno
- Ministry of Science, Technological Development, and Innovation of the Republic of Serbia
Según 2 financiadores declarados y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2023-08-10 · Pharmaceuticals (Basel) · vol. 16 · número 8 · pág. 1129
- Editorial
- Multidisciplinary Digital Publishing Institute
- Citado
- 23 citas · más que el 95% de estudios similares · 4.7× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 32 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY
- Áreas de investigación
- Drug-Induced Hepatotoxicity and Protection · Phytochemicals and Medicinal Plants · Poisoning and overdose treatments
- Palabras clave
- Medicine, Withania somnifera, Liver injury, Herb, Traditional medicine, Liver function tests, Alanine transaminase, Liver function, Internal medicine, Medicinal herbs, Pathology, Alternative medicine
7 autores
- Goran Bokan🇧🇦 · autor de correspondenciaUniversity clinical center of Republika Srpska
- Tanja Glamočanin🇧🇦University of Banja Luka; University clinical center of Republika Srpska
- Zoran Mavija🇧🇦University of Banja Luka; University clinical center of Republika Srpska
- Bojana B. Vidović🇷🇸University of Belgrade
- Ana Stojanović🇷🇸University Hospital Medical Center Bezanijska kosa
- Einar Stefan Bjornsson🇮🇸 · autor de correspondenciaReykjavík University; University of Iceland; National University Hospital of Iceland
- Vesna Vučić🇷🇸University of Belgrade; Centre of Research Excellence in Nutrition and Metabolism
Resumen
El texto original del estudio, en el idioma en que se publicó.
Herb-induced liver injury (HILI) caused by herbal supplements, natural products, and products used in traditional medicine are important for differential diagnoses in patients with acute liver injury without an obvious etiology. The root of Withania somnifera (L.) Dunal, commonly known as ashwagandha, has been used in Ayurvedic medicine for thousands of years to promote health and longevity. Due to various biological activities, ashwagandha and its extracts became widespread as herbal supplements on the global market. Although it is generally considered safe, there are several reported cases of ashwagandha-related liver injury, and one case ended with liver transplantation. In this paper, we review all reported cases so far. Additionally, we describe two new cases of ashwagandha hepatotoxicity. In the first case, a 36-year-old man used ashwagandha capsules (450 mg, three times daily) for 6 months before he developed nausea, pruritus, and dark-colored urine. In the second case, a 30-year-old woman developed pruritus after 45 days of using ashwagandha capsules (450 mg). In both cases, serum bilirubin and liver enzymes (aspartate transaminase (AST), alanine transaminase (ALT), and alkaline phosphatase (ALP) were increased. The liver injury pattern was hepatocellular (R-value 11.1) and mixed (R-value 2.6), respectively. The updated Roussel Uclaf Causality Assessment Method (RUCAM) (both cases with a score of seven) indicated a "probable" relationship with ashwagandha. Clinical and liver function improvements were observed after the discontinuation of ashwagandha supplement use. By increasing the data related to ashwagandha-induced liver injury, these reports support that consuming ashwagandha supplements is not without its safety concerns.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY).
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