Iberogast®-Induced Acute Liver Injury—A Case Report
Alternative medicines such as phytotherapy and herbal preparations have been widely used over the past 5 decades. However, they are still poorly known in Western medicine, and because they are considered as natural products, they are often omitted in the review of medication. One of the most used he...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Gastro Hep Advances |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772572322000383 |
| _version_ | 1811230142858526720 |
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| author | Alice Leroy Henri Perrin Raphael Porret Christine Sempoux Haithem Chtioui Montserrat Fraga Pierre-Alexandre Bart |
| author_facet | Alice Leroy Henri Perrin Raphael Porret Christine Sempoux Haithem Chtioui Montserrat Fraga Pierre-Alexandre Bart |
| author_sort | Alice Leroy |
| collection | DOAJ |
| description | Alternative medicines such as phytotherapy and herbal preparations have been widely used over the past 5 decades. However, they are still poorly known in Western medicine, and because they are considered as natural products, they are often omitted in the review of medication. One of the most used herbal preparations in Europe is Iberogast®, a formulation of 9 medicinal plant extracts, including Greater Celandine that has proven effective in the treatment of functional dyspepsia and irritable bowel syndrome. Safety and tolerability of Iberogast® were extensively evaluated in double-blind and randomized studies vs placebo, but rare and usually mild adverse symptoms have been reported in the literature. We report a 32-year-old female with no previous medical history who presented to the emergency department with abdominal pain, jaundice, and pruritus. The blood tests revealed an acute severe hepatitis with marked increase of direct bilirubin. After exclusion of other possible acute liver injury etiologies, we retained the diagnosis of Iberogast®-associated drug-induced liver injury. Patient’s symptoms resolved spontaneously 5 weeks after treatment interruption. Despite the general safety of Iberogast®, occasional cases of drug-induced liver injury have been documented. Based on these observations, we recommend that the use of herbal and phytotherapeutic products should be part of the standard investigation of the medical history, as they could be relevant information in the diagnosis process of acute liver injury. |
| first_indexed | 2024-04-12T10:25:20Z |
| format | Article |
| id | doaj.art-cefbe18b7112476fb92d083754f37409 |
| institution | Directory Open Access Journal |
| issn | 2772-5723 |
| language | English |
| last_indexed | 2024-04-12T10:25:20Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gastro Hep Advances |
| spelling | doaj.art-cefbe18b7112476fb92d083754f374092022-12-22T03:36:59ZengElsevierGastro Hep Advances2772-57232022-01-0114601603Iberogast®-Induced Acute Liver Injury—A Case ReportAlice Leroy0Henri Perrin1Raphael Porret2Christine Sempoux3Haithem Chtioui4Montserrat Fraga5Pierre-Alexandre Bart6Service de Médecine interne, CHUV, Lausanne, Switzerland; Correspondence: Address correspondence to: Alice Leroy, Service de Médecine interne, CHUV, Rue du Bugnon, 21, Lausanne 1011, Switzerland.Service de Médecine interne, CHUV, Lausanne, SwitzerlandService de Médecine interne, CHUV, Lausanne, SwitzerlandService de Pathologie Clinique, CHUV, Lausanne, SwitzerlandService de Pharmacologie clinique, CHUV, Lausanne, SwitzerlandService de Gastro-entérologie et d’hépatologie, CHUV, Lausanne, SwitzerlandService de Médecine interne, CHUV, Lausanne, SwitzerlandAlternative medicines such as phytotherapy and herbal preparations have been widely used over the past 5 decades. However, they are still poorly known in Western medicine, and because they are considered as natural products, they are often omitted in the review of medication. One of the most used herbal preparations in Europe is Iberogast®, a formulation of 9 medicinal plant extracts, including Greater Celandine that has proven effective in the treatment of functional dyspepsia and irritable bowel syndrome. Safety and tolerability of Iberogast® were extensively evaluated in double-blind and randomized studies vs placebo, but rare and usually mild adverse symptoms have been reported in the literature. We report a 32-year-old female with no previous medical history who presented to the emergency department with abdominal pain, jaundice, and pruritus. The blood tests revealed an acute severe hepatitis with marked increase of direct bilirubin. After exclusion of other possible acute liver injury etiologies, we retained the diagnosis of Iberogast®-associated drug-induced liver injury. Patient’s symptoms resolved spontaneously 5 weeks after treatment interruption. Despite the general safety of Iberogast®, occasional cases of drug-induced liver injury have been documented. Based on these observations, we recommend that the use of herbal and phytotherapeutic products should be part of the standard investigation of the medical history, as they could be relevant information in the diagnosis process of acute liver injury.http://www.sciencedirect.com/science/article/pii/S2772572322000383Iberogast®/STW 5Greater CelandineDrug-Induced Liver Injury (DILI)Herbal PreparationsPhytotherapy |
| spellingShingle | Alice Leroy Henri Perrin Raphael Porret Christine Sempoux Haithem Chtioui Montserrat Fraga Pierre-Alexandre Bart Iberogast®-Induced Acute Liver Injury—A Case Report Gastro Hep Advances Iberogast®/STW 5 Greater Celandine Drug-Induced Liver Injury (DILI) Herbal Preparations Phytotherapy |
| title | Iberogast®-Induced Acute Liver Injury—A Case Report |
| title_full | Iberogast®-Induced Acute Liver Injury—A Case Report |
| title_fullStr | Iberogast®-Induced Acute Liver Injury—A Case Report |
| title_full_unstemmed | Iberogast®-Induced Acute Liver Injury—A Case Report |
| title_short | Iberogast®-Induced Acute Liver Injury—A Case Report |
| title_sort | iberogast r induced acute liver injury a case report |
| topic | Iberogast®/STW 5 Greater Celandine Drug-Induced Liver Injury (DILI) Herbal Preparations Phytotherapy |
| url | http://www.sciencedirect.com/science/article/pii/S2772572322000383 |
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