Herbal and dietary supplements are commonly used in Western populations.
There is low public awareness of the potential hepatotoxicity of these agents.
Dr Jason Estes and his team at a hospital in Oregan, USA, investigated the cause of liver injury in 20 patients referred to the liver transplantation service for fulminant liver failure.
Fulminant hepatic failure was defined as onset of encephalopathy within 8 weeks of onset of jaundice in the absence of preexisting liver disease.
10 out of 20 (50%) of patients were recent or active users of herbs or dietary supplements with previously published reports of hepatic injury related to their use.
The remaining 10 patients had no history of supplement use
In the supplement group, 7 patients had no other identified cause for hepatic failure.
Supplement use alone accounted for the most cases of fulminant hepatic failure during the study period, exceeding acetaminophen toxicity and viral hepatitis.
Dr Estes concludes "Enhanced public awareness of the potential hepatotoxicity of these commonly used agents is needed"
|50% of patients with liver failure were recent or active users of potentially hepatotoxic herbs or dieatry supplements.|
|Archives of Surgery|
"Increased regulatory oversight of the use of these supplements is strongly urged."