Ashwagandha-induced liver injury-A case series from India and literature review
Philips CA, Philips CA, Valsan A, Theruvath AH, Ravindran R, Oommen TT, Rajesh S, Bishnu S, Augustine P, Liver Research Club India
Hepatology communications · 36 citas
Etiquetas de revisión
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Cómo se estudió
- Diseño
- Reporte de caso (clasificado por nuestro filtro de IA)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2023-09-27 · Hepatol Commun · vol. 7 · número 10
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 55 citas · más que el 100% de estudios similares · 17.3× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 30 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY-NC-ND
- Áreas de investigación
- Phytochemicals and Medicinal Plants · Drug-Induced Hepatotoxicity and Protection · Medical Case Reports and Studies
- Palabras clave
- Medicine, Liver injury, Chronic liver disease, Internal medicine, Liver disease, Traditional medicine
- MeSH
- humans, hepatitis, plant extracts, retrospective studies, india, male, acute-on-chronic liver failure, chemical and drug induced liver injury, chemical and drug induced liver injury, chronic
8 autores
- Cyriac Abby Philips🇮🇳 · autor de correspondenciaAmrita Institute of Medical Sciences and Research Centre; Rajagiri Hospital
- Arun Valsan🇮🇳Rajagiri Hospital
- Arif Hussain Theruvath🇮🇳Amrita Institute of Medical Sciences and Research Centre
- R. D. Ravindran🇮🇳Amrita Institute of Medical Sciences and Research Centre
- Tharun Tom Oommen🇮🇳Rajagiri Hospital
- S Rajesh🇮🇳Rajagiri Hospital
- Saptarshi Bishnu
- Philip Augustine🇮🇳Rajagiri Hospital
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Ashwagandha herb is commonly used in Ayurveda and a "fad" dietary supplement for a host of indications based on low levels of evidence. Recently, ashwagandha was implicated in multiple reports of herb-induced liver injury (HILI), mainly from the United States. We present the first, and currently largest, series of ashwagandha-HILI from multiple centers in India.
Methods
We retrospectively analyzed the respective institutional electronic medical records for ashwagandha-HILI. Patients consuming ashwagandha as part of multiherbal formulations or along with other known hepatotoxic supplements or medicines were excluded. All patients underwent a detailed diagnostic workup to exclude competing causes reasonably. Where possible, the implicated herbal formulation was retrieved and subjected to chemical analysis.
Results
Out of 23 patients with liver injury from ashwagandha (January 2019 to December 2022), we report 8 patients with single-ingredient formulation-related HILI. Study cohort was male predominant, and cholestatic hepatitis was the commonest presentation. Five patients had underlying chronic liver disease; 3 presented with acute-on-chronic liver failure, and all 3 died on follow-up. In others, the liver injury was prolonged, nonetheless self-limiting. Liver biopsy revealed cholestatic features predominantly with hepatocellular necrosis and lymphocyte/eosinophil predominant portal-based inflammation. One patient progressed to chronic HILI. Chemical analysis revealed only natural phytochemicals without adulteration or contamination.
Conclusions
Ashwagandha-HILI presents with cholestatic hepatitis and can lead to the syndrome of acute-on-chronic liver failure with high mortality in those with pre-existing liver disease. Educating the public on avoiding the use of potentially toxic and unrecommended herbal supplements can help mitigate the avoidable liver disease burden in the community.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY-NC-ND).
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