Title
Herbal and Dietary Supplements-Induced Liver Injury in Latin America: Experience From the LATINDILI Network
Date Issued
01 March 2022
Access level
metadata only access
Resource Type
journal article
Author(s)
Bessone F.
García-Cortés M.
Medina-Caliz I.
Hernandez N.
Parana R.
Mendizabal M.
Schinoni M.I.
Ridruejo E.
Nunes V.
Peralta M.
Santos G.
Anders M.
Chiodi D.
Tagle M.
Montes P.
Carrera E.
Arrese M.
Lizarzabal M.I.
Alvarez-Alvarez I.
Caballano-Infantes E.
Niu H.
Pinazo J.
Cabello M.R.
Lucena M.I.
Andrade R.J.
Publisher(s)
W.B. Saunder
Abstract
Background: Herbal and dietary supplements (HDS) consumption, a growing cause of hepatotoxicity, is a common practice among Latin-American populations. Objectives: To evaluate clinical, laboratory features and outcome in HDS-hepatotoxicity included in the Latin America-Drug Induced Liver Injury (LATINDILI) Network. Methods: A total of 29 adjudicated cases of HDS hepatotoxicity reported to the LATINDILI Network from October 2011 through December 2019 were compared with 322 DILI cases due to conventional drugs and 16 due to anabolic steroids as well as with other series of HDS-hepatotoxicity. Results: From 367 DILI cases, 8% were attributed to HDS. An increasing trend in HDS-hepatotoxicity was noted over time (p =.04). Camellia sinensis, Herbalife® products, and Garcinia cambogia, mostly used for weight loss, were the most frequently adjudicated causative agents. Mean age was 45 years (66% female). Median time to onset was 31 days. Patients presented typically with hepatocellular injury (83%) and jaundice (66%). Five cases (17%) developed acute liver failure. Compared to conventional medications and anabolic steroids, HDS hepatotoxicity cases had the highest levels of aspartate and alanine transaminase (p =.008 and p =.021, respectively), had more re-exposure events to the culprit HDS (14% vs 3% vs 0%; p =.026), and had more severe and fatal/liver transplantation outcomes (21% vs 12% vs 13%; p =.005). Compared to other DILI cohorts, less HDS hepatotoxicity cases in Latin America were hospitalized (41%). Conclusions: HDS-hepatotoxicity in Latin-America affects mainly young women, manifests mostly with hepatocellular injury and is associated with higher frequency of accidental re-exposure. HDS hepatotoxicity is more serious with a higher chance of death/liver transplantation than DILI related to conventional drugs.
Start page
e548
End page
e563
Volume
20
Issue
3
Language
English
OCDE Knowledge area
Gastroenterología, Hepatología
Subjects
Scopus EID
2-s2.0-85111735058
PubMed ID
Source
Clinical Gastroenterology and Hepatology
ISSN of the container
15423565
Sponsor(s)
Funding Supported by grants of the Andalusian Health Service (SAS) (contract number: PI-0285-2016). Instituto de Salud Carlos III co-funded by Fondo Europeo de Desarrollo Regional – FEDER (contract numbers PI-0274-2016, PI-0285-2016, PI-0310-2018, PI18-00901, PI18/01804). IAA holds a Sara Borrell research contract from the National Health System, ISCiii (CD 20/00083), and by the Agencia Española del Medicamento. CIBERehd is funded by Instituto de Salud Carlos III .
Sources of information:
Directorio de Producción Científica
Scopus