Association between consumption of Herbalife® nutritional supplements and acute hepatotoxicity

被引:84
|
作者
Elinav, Eran
Pinsker, Galia
Safadi, Rifaat
Pappo, Orit
Bromberg, Michal
Anis, Emilia
Keinan-Boker, Lital
Broide, Efrat
Ackerman, Zvi
Kaluski, Dorit Nitzan
Lev, Boaz
Shouval, Daniel
机构
[1] Hadassah Hebrew Univ Jerusalem, Med Ctr, Liver Unit, IL-91120 Jerusalem, Israel
[2] Hadassah Hebrew Univ, Med Ctr, Dept Pathol, Jerusalem, Israel
[3] Hadassah Hebrew Univ, Med Ctr, Dept Med, Jerusalem, Israel
[4] Assaf Harofeh Med Ctr, Inst Gastroenterol, IL-70300 Zerifin, Israel
关键词
hepatitis; hepatotoxicity; Herbalife (R); herbal supplements;
D O I
10.1016/j.jhep.2007.06.016
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background/Aims: Nutritional supplements are frequently considered to be harmless but indiscriminate use of unlabelled ingredients may lead to significant adverse reactions. Methods: In 2004, identification of four index cases of acute hepatitis associated with Herbalife (R) intake led to a ministry of health investigation in all Israeli hospitals. Twelve patients with acute idiopathic liver injury in association with consumption of Herbalife (R) products were investigated. Results: Eleven of the patients were females, aged 49.5 +/- 13.4 y. One patient had stage I primary biliary cirrhosis and another had hepatitis B. Acute liver injury was diagnosed after 11.9 +/- 11.1 months of initiation of Herbalife (R) consumption. Liver biopsies demonstrated active hepatitis, portal inflammation rich with eosinophils, ductular reaction and parenchymal inflammation with peri-central accentuation. One patient developed sub-fulminant and two fulminant episodes of hepatic failure. Hepatitis resolved in eleven patients, while one patient succumbed to complications following liver transplantation. Three patients resumed consumption of Herbalife (R) products following normalization of liver enzymes, resulting in a second bout of hepatitis. Conclusions: An association between intake of Herbalife (R) products and acute hepatitis was identified in Israel. We call for prospective evaluation of Herbalife (R) products for possible hepatotoxicity. Until then, caution should be exercised by consumers, especially among individuals suffering from underlying liver disease. (C) 2007 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:514 / 520
页数:7
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