Clinical outcomes, histopathological patterns, and chemical analysis of Ayurveda and herbal medicine associated with severe liver injury-A single-center experience from southern India

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
Cyriac Abby PhilipsPhilip Augustine

Abstract

Ayurvedic and herbal medicines (AHM) are known to cause varying degrees of drug-induced liver injury (DILI). Clinical, biochemical, histological spectrum and outcomes of AHM linked to severe DILI are not well studied. Out of 1440 liver disease patients, 94 were found to have a severe liver injury and associated AHM intake. Thirty-three patients were suspected to have AHM-DILI on Roussel Uclaf Causality Assessment Scoring Method. Forty-seven and 30 of retrieved AHM samples were analyzed for heavy metals and hepatotoxic volatile organic compounds (hVOCs), respectively. Eleven patients ingested AHM from unregistered traditional healers (UTH). Clinicopathological outcomes were analyzed in 27 patients (who underwent liver biopsy) and outcomes with respect to chemical analyses were studied in 33 patients. Males predominated (70.4%) with mean age 46.9±15.8 years. Mean follow up was 119.2±81.4 days. The median duration of drug intake was 28 days (10 - 84). Five patients died (18.5%). Hepatic encephalopathy, hypoalbuminemia, and hepatic necrosis were significantly associated with mortality (p < 0.005). Arsenic and mercury ingestion was significantly associated with death (p < 0.005). hVOCs were detected in more than 70% of samples. AHM ...Continue Reading

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Citations

Feb 10, 2018·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Harshad Devarbhavi
Oct 22, 2018·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Mark RealJames H Lewis
Jul 16, 2019·Hepatology Communications·Cyriac Abby PhilipsGuruprasad Padsalgi
Jan 10, 2020·Journal of Clinical and Translational Hepatology·Cyriac Abby PhilipsPhilip Augustine
Sep 1, 2018·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Preethi Mohan
Sep 1, 2018·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Sanjeev Rastogi
Aug 20, 2018·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Cyriac Abby PhilipsPhilip Augustine
Oct 15, 2019·Journal of Clinical and Translational Hepatology·Cyriac Abby PhilipsDeepak Madhu
Aug 20, 2018·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Cyriac Abby PhilipsPhilip Augustine
Oct 10, 2020·World Journal of Hepatology·Cyriac Abby PhilipsPhilip Augustine
Mar 1, 2021·Hepatology International·Harshad DevarbhaviUNKNOWN Asia Pacific Association of Study of Liver
Mar 23, 2021·Journal of Clinical and Experimental Hepatology·Nanjegowda Sunil KumarKandiyil Sunil Kumar
May 18, 2021·Journal of Clinical and Experimental Hepatology·Harshad Devarbhavi Shalimar

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