Association between consumption of Herbalife® nutritional supplements and acute hepatotoxicity
Association between consumption of Herbalife® nutritional supplements and acute hepatotoxicity
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DOI：
10.1016/j.jhep.2007.06.016
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发表时间：
2007-10-01
影响因子：
25.7
通讯作者：
Shouval, Daniel
中科院分区：
文献类型：
--
作者：
Elinav, Eran;Pinsker, Galia;Shouval, Daniel
背景/目的：营养补充剂通常被认为是无害的，但滥用未标记的成分可能会导致严重的不良反应。 方法：2004 年，确定了四例与康宝莱 (R) 摄入相关的急性肝炎指示病例，导致卫生部对以色列所有医院进行了调查。对 12 名与食用 Herbalife (R) 产品相关的急性特发性肝损伤患者进行了调查。结果：其中 11 名患者为女性，年龄 49.5 +/- 13.4 岁。一名患者患有 I 期原发性胆汁性肝硬化，另一名患者患有乙型肝炎。在开始服用 Herbalife (R) 11.9 +/- 11.1 个月后诊断出急性肝损伤。肝活检显示活动性肝炎、富含嗜酸性粒细胞的门静脉炎症、导管反应和周围中央加重的实质炎症。一名患者出现亚暴发性肝衰竭和两次暴发性肝衰竭。 11 名患者的肝炎得到缓解，而一名患者则因肝移植后的并发症而死亡。三名患者在肝酶正常化后恢复使用 Herbalife (R) 产品，导致第二次肝炎。结论：在以色列发现 Herbalife (R) 产品的摄入与急性肝炎之间存在关联。我们呼吁对 Herbalife (R) 产品可能的肝毒性进行前瞻性评估。在此之前，消费者应谨慎行事，尤其是患有潜在肝病的个人。 (C) 2007 年欧洲肝脏研究协会。由 Elsevier B.V. 出版。保留所有权利。
Background/Aims: Nutritional supplements are frequently considered to be harmless but indiscriminate use of unlabelled ingredients may lead to significant adverse reactions.Methods: In 2004, identification of four index cases of acute hepatitis associated with Herbalife (R) intake led to a ministry of health investigation in all Israeli hospitals. Twelve patients with acute idiopathic liver injury in association with consumption of Herbalife (R) products were investigated.Results: Eleven of the patients were females, aged 49.5 +/- 13.4 y. One patient had stage I primary biliary cirrhosis and another had hepatitis B. Acute liver injury was diagnosed after 11.9 +/- 11.1 months of initiation of Herbalife (R) consumption. Liver biopsies demonstrated active hepatitis, portal inflammation rich with eosinophils, ductular reaction and parenchymal inflammation with peri-central accentuation. One patient developed sub-fulminant and two fulminant episodes of hepatic failure. Hepatitis resolved in eleven patients, while one patient succumbed to complications following liver transplantation. Three patients resumed consumption of Herbalife (R) products following normalization of liver enzymes, resulting in a second bout of hepatitis.Conclusions: An association between intake of Herbalife (R) products and acute hepatitis was identified in Israel. We call for prospective evaluation of Herbalife (R) products for possible hepatotoxicity. Until then, caution should be exercised by consumers, especially among individuals suffering from underlying liver disease. (C) 2007 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.