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Chinese herbs and bone disease.
Junichi Hoshino1, Yoshifumi Ubara, Tetsuo Tagami
1Kidney Center, Toranomon Hospital, Tokyo.
Internal Medicine (Tokyo, Japan)
|May 6, 2003
Summary
This study reports a rare bone disease in a patient consuming Chinese herbs, leading to kidney dysfunction and severe bone pain. Etidronate disodium effectively managed the bone symptoms, suggesting a novel herb-induced condition.
Area of Science:
- Nephrology
- Endocrinology
- Rheumatology
Background:
- A 65-year-old male developed multifocal osteoarthralgias and renal dysfunction after consuming Chinese herbs for seven years.
- The patient presented with elevated serum creatinine (2.8 mg/dl), urea nitrogen (19 mg/dl), and Fanconi syndrome.
Observation:
- Renal biopsy revealed tubulo-interstitial fibrosis.
- Despite discontinuing Chinese herbs and initiating prednisolone, bone and joint pain, and renal function progressively worsened.
- Radiographs did not show osteosclerosis or hypertrophy, initially leading to suspicion of Paget's disease, which was later ruled out.
Findings:
- Histological examination of bone specimens diagnosed a mixed-type renal osteodystrophy, including osteomalacia and osteitis fibrosa.
- The patient's condition was distinct from typical renal osteodystrophy seen in dialysis patients and Paget's disease.
- Etidronate disodium treatment proved effective in alleviating the patient's bone symptoms.
Implications:
- This case suggests a potential new bone disease possibly linked to Chinese herbal consumption, independent of nephropathy.
- Further research is warranted to elucidate the specific mechanisms and causative agents within Chinese herbs responsible for this bone disorder.
- The findings highlight the importance of considering iatrogenic causes, including herbal remedies, in the differential diagnosis of complex bone and renal diseases.