Oral aloe vera-induced hepatitis

Area of Science:

• Hepatology
• Clinical Pharmacology
• Herbal Medicine Safety

Background:

• Herbal medications are increasingly used, posing potential patient safety risks.
• The safety profile of many herbal products, including oral aloe vera, is not well-established.
• Hepatic toxicity from herbal agents is an underreported area in medical literature.

Observation:

• A 73-year-old female presented with acute hepatitis of unknown etiology.
• Extensive investigations failed to identify a cause for the liver injury.
• The patient admitted to oral aloe vera capsule use for constipation after detailed medication history.

Findings:

• Discontinuation of oral aloe vera led to the normalization of liver enzymes.
• The Naranjo probability scale indicated possible hepatotoxicity related to oral aloe vera.
• The Roussel Uclaf Causality Assessment Method suggested probable causation by oral aloe vera.

Implications:

• Clinicians should consider herbal product use, such as oral aloe vera, in cases of unexplained acute hepatitis.
• Increased awareness and reporting of adverse events related to herbal supplements are crucial.
• The lack of stringent regulatory oversight for herbal products in some regions necessitates caution.