Hepatic Damage by Natural Remedies

Area of Science:

• Hepatology
• Toxicology
• Pharmacovigilance

Background:

• Herbal and dietary supplement hepatotoxicity (HILI) presents a growing public health challenge in Western nations.
• Estimated incidence rates from prospective studies range from 1 to 3 cases per 100,000 individuals annually.
• HILI poses diagnostic difficulties for healthcare professionals due to concealed usage and product complexities.

Purpose of the Study:

• To highlight the unique characteristics and diagnostic challenges associated with herbal hepatotoxicity.
• To underscore the need for improved recognition and reporting of HILI cases.
• To advocate for collaborative research for better understanding of HILI.

Main Methods:

• Review of existing literature and prospective studies on HILI incidence and characteristics.
• Analysis of clinical presentation, diagnostic hurdles, and outcomes in HILI patients.
• Discussion of factors contributing to misidentification and inaccurate reporting.

Main Results:

• HILI exhibits a distinct profile: female predominance, hepatocellular injury with elevated transaminases, frequent unintentional re-exposure, and increased risk of mortality or liver transplantation.
• Challenges include obscured herbal product consumption, difficulty in pinpointing causative agents, and issues of contamination, adulteration, or misidentification.
• These factors complicate case adjudication and scientific reporting.

Conclusions:

• Enhanced recognition and accurate reporting of HILI are crucial for patient safety and public health.
• Collaborative efforts to collect detailed patient data and biological samples are essential.
• Such initiatives will support genomic and molecular research to identify host risk factors and potential biomarkers for HILI.