Related Experiment Video
Updated: Jun 5, 2026
11:06
Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
Published on: January 31, 2022
Herbal hepatotoxicity: a case of difficult interpretation
G Valente1, M Sanges, S Campione
1Gastroenterology Unit, Federico II University, Naples, Italy.
European Review for Medical and Pharmacological Sciences
|January 13, 2011
Summary
Herbal products can cause liver injury, as seen in a case of mixed cholestatic/hepatocellular damage. Prompt diagnosis and treatment with ursodeoxycholic acid (UDCA) normalized liver function.
Area of Science:
- Hepatology
- Clinical Toxicology
Background:
- Herbal medicines are globally prevalent, often perceived as safe, yet possess potential hepatotoxic risks.
- Liver injury from herbal products remains an underrecognized clinical challenge.
Observation:
- A woman presented with jaundice and abdominal pain, initially suspected as biliary obstruction and treated with cholecystectomy.
- Persistent elevation of liver enzymes led to further investigation, excluding other hepatitis causes.
- Detailed patient history revealed the use of herbal products, prompting a diagnosis of herbal-induced liver injury.
Findings:
- Liver biopsy confirmed hepatotoxic injury.
- Treatment with ursodeoxycholic acid (UDCA) resulted in normalization of liver function tests within two months.
Implications:
- Highlights the critical need for physician awareness regarding the efficacy and adverse effects of herbal medicines.
- Emphasizes the importance of open doctor-patient communication regarding phytotherapy use for timely diagnosis and management of herbal product-induced liver injury.
Related Concept Videos
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...
01:16Drug toxicity: Idiosyncratic Reactions
Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...
01:14Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug
In pharmacotherapy, monitoring drug concentrations is paramount, especially for drugs whose therapeutic effects hinge on both the active compound and its metabolite. Hepatic impairment profoundly influences drug potency by altering liver function. If the drug is more potent than its metabolite, impaired liver function amplifies drug activity due to elevated drug concentration levels. Conversely, if the metabolite holds greater potency, diminished liver function diminishes drug activity by...
01:16Hepatic Drug Excretion: Influencing Factors
The biliary system of the liver, crucial for bile secretion and drug excretion, comprises intrahepatic bile ducts that merge to form the common hepatic duct. This duct, carrying hepatic bile, combines with the cystic duct, draining the gallbladder and forming the common bile duct, which empties into the duodenum. Bile, produced by hepatic cells lining the bile canaliculi, is composed primarily of water, bile salts, pigments, electrolytes, and lesser amounts of cholesterol and fatty acids. Bile...
01:00Drug Toxicity: Overview
Drug toxicity quantifies the harm a compound causes to an organism, varying by dose and potentially impacting whole systems or specific organs like the liver. Toxic reactions may arise from venomous insect or spider bites, with effects ranging from mild symptoms to severe outcomes such as brain damage or death. Common forms of acute poisoning include ethanol intoxication and overdose of pain or fever medications, with substances like GHB and heroin being particularly lethal at doses close to...