Bitki çayı Teucrium chamaedrys alımına bağlı gelişen bir akut hepatit olgusu

Year 2011, Volume: 68 Issue: 3, 135 - 138, 01.09.2011

Onur Ural Özgür Satılmış Gaye Ural Nebahat Dikici

Abstract

Türkiye’de bitkisel tedavilere bağlı toksik bulgulara pek sık rastlanmamaktadır. Olgumuz 33 yaşında bir bayan hastadır. Sarılık şikayeti ile başvuran olgunun yaklaşık iki haftadır, her gün Teucrium chamaedrys bitkisini içeren bir çayı aldığı öğrenilmiştir. Hastada akut ikterik hepatit bulguları saptanmış ve akut hepatit yapabilecek başka bir neden tespit edilememiştir. T. chamaedrys alımı sonlandırılıp takip edilen hastada klinik iyileşme izlenmiş ve yaklaşık dokuz hafta içinde serum bilirubin, aminotransferaz, alkalen fosfataz düzeyleri normal sınırlara düşmüştür. Bu olgu T. chamaedrys alımının akut ikterik hepatite neden olabileceği, klinik olarak akut viral hepatitleri taklit edebileceği ve bitkisel tedavilerin genel olarak kabul edildiği kadar güvenli olmadığını göstermektedir

Keywords

Bitkisel tedavi, Teucrium chamaedrys, hepatit

A case: Acute hepatitis associated with herbal Teucrium chamaedrys ingestion

Abstract

Herbal medicine toxicity has been infrequently reported in Turkey. Our case describes a 33- year-old woman who applied with jaundice. She acknowledged that she was taking daily a tea containing the plant Teucrium chamaedrys for two weeks. It was determined she had symptoms of acute icteric hepatitis. Other causes of acute hepatitis were excluded. After T. chamaedrys was not taken anymore by the patient, she recovered clinically and her serum bilirubin, aminotransferases and alkaline phosphatase values returned to normal levels within 9-weeks. This case suggests that T. chamaedrys intake may cause acute icteric hepatitis which might clinically mimic acute viral hepatitis, and it shows that herbal medicines are not as safe as they have been generally assumed

Keywords

Herbal treatment, Teucrium chamaedrys, hepatitis

References

• Mallory MA, Lee SW, Kowdley KV. Abnormal liver test results on routine screening: How to evaluate, when to refer for a biopsy. Postgrad Med, 2004; 115: 53-62
• Stickel F, Egerer G, Seitz HK. Hepatotoxicity of botanicals. Public Health Nutr, 2000; 3: 113-24.
• Woolf GM, Petrovic LM, Rojter SE, Wainwright S, Villamil FG, Katkov WN et al. Acute hepatitis associated with the Chinese herbal product jin bu huan. Ann Intern Med, 1994; 121: 729-35.
• Sanders D, Kennedy N, McKendrick MW. Monitoring the safety of herbal remedies. Herbal remedies have a heterogeneous nature. BMJ, 1995; 311: 1569.
• Larrey D, Vial T, Pauwels A, Castot A, Biour M, David M et al. Hepatitis after germander (Teucrium chamaedrys) administration: another instance of herbal medicine hepatotoxicity. Ann Intern Med, 1992; 117: 165-6.
• Dourakis SP, Papanikolaou IS, Tzemanakis EN, Hadziyannis SJ. Acute hepatitis associated with herb (Teucrium capitatum L.) administration. Eur J Gastroenterol Hepato, 2002;14:693-5.
• Bedir E, Manyam R, Khan IA. Neo-clerodane diterpenoids and phenylethanoid glycosides from Teucrium chamaedrys L. Phytochemistry, 2003; 63:977-83.
• Haller CA, Dyer JE, Ko R, Olson KR. Making a diagnosis of herbal-related toxic hepatitis. West J Med, 2002; 176: 39-44.
• Loeper J, Descatoire V, Letteron P, Moulis C, Degott C, Dansette P et al. Hepatotoxicity of germander in mice. Gastroenterol, 1994; 106: 464-72.
• Savona G, Garcia-Alvarez MC, Rodriguez B. Dihydroteugin, a neo-clerodane diterpenoid from Teucrium chamaedrys. Phytochemistry, 1982; 21: 721-3
• Mostefa-Kara N, Pauwels A, Pines E, Biour M, Levy VG. Fatal hepatitis after herbal tea. Lancet, 1992; 340: 674.
• Refik Saydam Hıfzıssıhha Merkezi Başkanlığı / Refik Saydam National Public Health Agency
• Türk Hijyen ve Deneysel Biyoloji Dergisi / Turkish Bulletin of Hygiene and Experimental Biology
• Yayın ve Dokümantasyon Müdürlüğü / Department of Publication and Documentation Sağlık Mah. Adnan Saygun Cad. No: 55 06100 Sıhhiye-ANKARA-TURKEY
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