Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network.
Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network.
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DOI：
10.1111/liv.14393
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发表时间：
2020-04
期刊：
影响因子：
--
通讯作者：
Navarro V
中科院分区：
文献类型：
--
作者：
Björnsson HK;Björnsson ES;Avula B;Khan IA;Jonasson JG;Ghabril M;Hayashi PH;Navarro V
Ashwagandha (Withania somnifera) is widely used in Indian Ayurvedic medicine. Several dietary supplements containing ashwagandha are marketed in the U.S. and Europe, but only one case of ashwagandha-induced liver injury (DILI) has been published. The aim of this case series was to describe the clinical phenotype of suspected ashwagandha induced liver injury. Five cases of liver injury attributed to ashwagandha-containing supplements were identified; three were collected in Iceland during 2017–2018 and two from the Drug-Induced Liver Injury Network (DILIN) in 2016. Other causes for liver injury were excluded. Causality was assessed using the DILIN structured expert opinion causality approach. Among the five patients, three were males; mean age 43 years (range 21–62). All patients developed jaundice and symptoms such as nausea, lethargy, pruritus and abdominal discomfort after a latency of 2–12 weeks. Liver injury was cholestatic or mixed (R ratios 1.4–3.3). Pruritus and hyperbilirubinemia were prolonged (5–20 weeks). No patient developed hepatic failure. Liver tests normalized within 1–5 months in 4 patients. One patient was lost to follow-up. One biopsy was performed, showing acute cholestatic hepatitis. Chemical analysis confirmed ashwagandha in available supplements; no other toxic compounds were identified. No patient was taking potentially hepatotoxic prescription medications, four were consuming additional supplements, in one case rhodiola was a possible causative agent along with ashwagandha. These cases illustrate the hepatotoxic potential of ashwagandha. Liver injury is typically cholestatic or mixed with severe jaundice and pruritus, but self-limited with liver tests normalizing in 1–5 months. Ashwaganda is a plant root which is used in many herbal- and dietary supplements. It seems to be able to cause injury to the liver and the injury has a specific clinical pattern. In this study the characteristics of five such cases are described.
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影响因子：
4.2
作者：
Bailey, Regan L.;Gahche, Jaime J.;Picciano, Mary Frances
通讯作者：
Picciano, Mary Frances
影响因子：
13.5
作者：
Lammert, Craig;Einarsson, Stefan;Chalasani, Naga
通讯作者：
Chalasani, Naga
DOI：
10.1002/hep.28813
发表时间：
2017-01
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Navarro VJ;Khan I;Björnsson E;Seeff LB;Serrano J;Hoofnagle JH
通讯作者：
Hoofnagle JH
影响因子：
4.2
作者：
Fontana RJ;Watkins PB;Bonkovsky HL;Chalasani N;Davern T;Serrano J;Rochon J;DILIN Study Group
通讯作者：
DILIN Study Group
DOI：
10.3390/molecules14072373
发表时间：
2009-07-03
期刊：
Molecules (Basel, Switzerland)
影响因子：
--
作者：
Mirjalili MH;Moyano E;Bonfill M;Cusido RM;Palazón J
通讯作者：
Palazón J