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Drug-induced liver injury due to “natural products” used for weight loss:A case report

World Journal of Gastroenterology 2009年第19期15卷 2414-2417页

作者： Giovanni Tarantino Martina Gilda Pezzullo Matteo Nicola Dario di Minno Francesco Milone Luigi Sossio Pezzullo Marco Milone Domenico Capone Department of Clinical & Experimental Medicine Federico II University Medical SchoolVia S.Pansini5 80131 NaplesItaly Department of General Surgery Federico II University Medical School5 80131 NaplesItaly Department of Neuroscience Section of Clinical PharmacologyFederico II University Medical School5 80131 NaplesItaly Department of General Surgery ASL BN1 of Benevento5 80131 NaplesItaly

Taking herbal-extracts to lose weight is an underestimated health ***,these products contain active agents that can cause acute liver *** this case report,a 22-year-old female patient,who presented with a feature of cholestatic syndrome,was so sure that the "natural products" were not dangerous that she did not inform her physicians that she had taken them,making their task that much more *** presentation mimicked acute cholecystitis and the patient underwent a *** was without any consequences and complications,although it did not completely cure the *** later admitted to having taken herbal remedies and this led to the correct diagnosis of phytotherapy-related hepatotoxicity and a successful therapeutic *** true incidence of phytotherapy-related hepatotoxicity and its pathogenic mechanisms are largely *** is important to increase the awareness of both clinicians and patients about the potential dangers of herbal remedies.

关键词： Drug-induced liver injury Obesity herbalremedies Cholecystitis

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Drug-induced liver injury:Is it somehow foreseeable?

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World Journal of Gastroenterology 2009年第23期15卷 2817-2833页

作者： Giovanni Tarantino Matteo Nicola Dario Di Minno Domenico Capone Depart-ment of Clinical and Experimental Medicine Section of Hepa-tology in Internal Medicine Federico Ⅱ University Medical School of Naples 5 80131 Napoli Italy Department of Neurosciences Unit of Clinical Pharmacology Federico Ⅱ University Medical School of Naples 5 80131 Napoli Italy

The classic view on the pathogenesis of drug-induced liver injury is that the so-called parent compounds are made hepatotoxic by metabolism (formation of neosubstances that react abnormally), mainly by cytochromes P-450 (CYP), with further pathways, such as mitochondrial dysfunction and apoptosis, also playing a role. Risk factors for drug-induced liver injury include concomitant hepatic diseases, age and genetic polymorphisms of CYP. However, some susceptibility can today be predicted before drug administration, working on the common substrate, by phenotyping and genotyping studies and by taking in consideration patients' health status. Physicians should always think of this adverse effect in the absence of other clear hepatic disease. Ethical and legal problems towards operators in the health care system are always matters to consider.

关键词： Drug-induced liver injury CytochromeP-450 Drug metabolism Pharmacogenomics herbalremedies

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