ArticleJournal of clinical and experimental hepatology
Herbal Immune Booster-Induced Liver Injury in the COVID-19 Pandemic - A Case Series.
Article in Journal of clinical and experimental hepatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Autoimmune hepatitis in children: Guidelines of the Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ISPGHAN).Hepatology international · 2025Guideline
- Status of evidence on efficacy and safety of Indian traditional medicine (Ayush) for COVID-19: a qualitative review and evidence map synthesis.Systematic reviews · 2026Review
- Analysis of 386 alternative medicinal products implicated in liver injury reveal clinically relevant associations with potentially hepatotoxic botanicals, pharmaceutical adulteration, heavy metal contamination, and undisclosed animal content.Frontiers in gastroenterology (Lausanne, Switzerland) · 2026Article
- Identifying immunostimulatory herbal supplements that may flare autoimmune skin diseases: a systematic scoping review.Lupus science & medicine · 2025Article
- Acute-on-chronic liver failure (ACLF): the 'Kyoto Consensus'-steps from Asia.Hepatology international · 2025Review
- Complementary and alternative medicines and liver disease.Hepatology communications · 2024Review
- Effect of Uncaria tomentosa aqueous extract on the response to palmitate-induced lipotoxicity in cultured skeletal muscle cells.BMC complementary medicine and therapies · 2023Article
- Nomenclature, diagnosis and management of drug-induced autoimmune-like hepatitis (DI-ALH): An expert opinion meeting report.Journal of hepatology · 2023Review
- Anti-F-Actin Antibody Positivity on Indirect Immunofluorescence Assay Following Chinese and Alternative Medicine Therapy: A Case Report.Journal of laboratory physicians · 2023Article
- Article
- OECD-407 Driven 28-day-repeated-dose non-clinical safety evaluation ofFrontiers in pharmacology · 2023Article
- Molecular Characterization ofGenes · 2022Article
- Hepatotoxicity due to herbal dietary supplements: Past, present and the future.Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association · 2022Review
- Article
- Plant Bioactives in the Treatment of Inflammation of Skeletal Muscles: A Molecular Perspective.Evidence-based complementary and alternative medicine : eCAM · 2022Review
- Knowledge of Herbal Medicines - Is a Reverse Bridge Course an Urgent Necessity?Journal of clinical and experimental hepatologyArticle
- Apparent Hepatotoxicity of Giloy (Journal of clinical and experimental hepatologyArticle
- Article
- Author Response to Letters on the Manuscript "Herbal Immune Booster-Induced Liver Injury in the COVID-19 Pandemic - A Case Series".Journal of clinical and experimental hepatologyArticle
- Probable Drug-Induced Liver Injury Caused byJournal of clinical and experimental hepatologyArticle
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5 authors.
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Abstract
The COVID-19 pandemic has resulted in widespread use of complementary and alternative medicines. Tinospora cordifolia is a widely grown shrub which has been commonly used in India's traditional system of Ayurveda for its immune booster properties and has been extensively used as prophylaxis against COVID-19. Six patients (4 women, 2 men) with a median (IQR) age of 55 years (45-56) and with an history of Tinospora cordifolia consumption presented with symptoms of acute hepatitis during the study period of 4 months in the COVID-19 pandemic. The median (IQR) duration of Tinospora cordifolia consumption was 90 days (21-210). The median (IQR) peak bilirubin and AST were 17.5 mg/dl (12.2-24.9) and 1350 IU/ml (1099-1773), respectively. The patients had either a definite (n = 4) or probable (n = 2) revised autoimmune hepatitis score with an autoimmune pattern of drug-induced liver injury on biopsy. Four of these patients (all women) had underlying silent chronic liver disease of possible autoimmune etiology associated with other autoimmune diseases - hypothyroidism and type 2 diabetes mellitus. One of the three patients treated with steroids decompensated on steroid tapering. The other five patients had resolution of symptoms, liver profile, and autoimmune serological markers on drug withdrawal/continuing steroid treatment. The median (IQR) time to resolution from discontinuing the herb was 86.5 days (53-111). Tinospora cordifolia consumption seems to induce an autoimmune-like hepatitis or unmask an underlying autoimmune chronic liver disease, which may support its immune stimulant mechanism. However, the same mechanism can cause significant liver toxicity, and we recommend that caution be exercised in the use of this herb, especially in those predisposed to autoimmune disorders. Besides, in patients presenting with acute hepatitis, even in the presence of autoimmune markers, a detailed complementary and alternative medicine history needs to be elicited.
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