ArticleIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2018
Clinical outcomes, histopathological patterns, and chemical analysis of Ayurveda and herbal medicine associated with severe liver injury-A single-center experience from southern India.
Article in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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34 citing papers in PubMed, 63 citations in OpenAlex.
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- Heavy Metals Like Aluminum, Arsenic, Cadmium, Chromium, Copper, Iron, Lead, Manganese, Mercury, Nickel, and Zinc Polluting the Drinking Water: Their Individual Health Hazards.International journal of molecular sciences · 2025Review
- Insights into medication-induced liver injury: Understanding and management strategies.Toxicology reports · 2025Review
- Etiopathogenic and Therapeutic Considerations in a Multiple Sclerosis Case with Acute Toxic Hepatitis.Reports (MDPI) · 2025Article
- Copper, Iron, Cadmium, and Arsenic, All Generated in the Universe: Elucidating Their Environmental Impact Risk on Human Health Including Clinical Liver Injury.International journal of molecular sciences · 2024Review
- Complementary and alternative medicines and liver disease.Hepatology communications · 2024Review
- Ayurvedic treatment induced severe alcoholic hepatitis and non-cirrhotic portal hypertension in a 14-year-old girl.Oxford medical case reports · 2022Article
- Toxic hepatitis-associated aplastic anaemia after dual homeopathic remedies and Gymnema sylvestre use.BMJ case reports · 2022Article
- Herbal and dietary supplement-induced liver injury in Taiwan: comparison with conventional drug-induced liver injury.Hepatology international · 2021Article
- Metabolic Toxification of 1,2-Unsaturated Pyrrolizidine Alkaloids Causes Human Hepatic Sinusoidal Obstruction Syndrome: The Update.International journal of molecular sciences · 2021Review
- Drug-Induced Liver Injury Unique to India.Clinical liver disease · 2021Review
- Drug-induced liver injury: Asia Pacific Association of Study of Liver consensus guidelines.Hepatology international · 2021Article
- Case series and review of Ayurvedic medication induced liver injury.BMC complementary medicine and therapies · 2021Review
- Herb-induced liver injury (HILI) with 12,068 worldwide cases published with causality assessments by Roussel Uclaf Causality Assessment Method (RUCAM): an overview.Translational gastroenterology and hepatology · 2021Review
- Article
- Worldwide Use of RUCAM for Causality Assessment in 81,856 Idiosyncratic DILI and 14,029 HILI Cases Published 1993-Mid 2020: A Comprehensive Analysis.Medicines (Basel, Switzerland) · 2020Review
- Comprehensive review of hepatotoxicity associated with traditional Indian Ayurvedic herbs.World journal of hepatology · 2020Review
- Outcomes and Toxicology of Herbal Drugs in Alcoholic Hepatitis - A Single Center Experience from India.Journal of clinical and translational hepatology · 2019Article
- Complementary and Alternative Medicine-related Drug-induced Liver Injury in Asia.Journal of clinical and translational hepatology · 2019Review
- Herb-Induced Liver Injury: Phylogenetic Relationship, Structure-Toxicity Relationship, and Herb-Ingredient Network Analysis.International journal of molecular sciences · 2019Review
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5 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionAyurvedic 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.
methodsOut 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.
resultsMales 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 intake from UTH was associated with higher mortality.
conclusionAdequate regulation and scrutiny regarding AHM use among the general population is an unmet need. Early liver biopsy after clinical identification of at-risk patients can expedite definitive treatment with a liver transplant.
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