RT Journal Article
T1 Herbal and dietary supplements-induced liver injury in Latin America: Experience from the LATINDILI Network
A1 Bessone, Fernando
A1 García-Cortés, Miren
A1 Medina-Cáliz, Inmaculada
A1 Hernandez, Nelia
A1 Parana, Raymundo
A1 Mendizabal, Manuel
A1 Schinoni, María I.
A1 Ridruejo, Ezequiel
A1 Nunes, Vinicius
A1 Peralta, Mirta
A1 Santos, Genario
A1 Anders, Margarita
A1 Chiodi, Daniela
A1 Tagle, Martin
A1 Montes, Pedro
A1 Carrera, Enrique
A1 Arrese, Marco
A1 Lizarzabal, M. Isabel
A1 Álvarez-Álvarez, Ismael
A1 Caballano-Infantes, Estefanía
A1 Niu, Hao
A1 Pinazo, Jose
A1 Cabello-Porras, María Rosario
A1 Lucena-González, María Isabel
A1 Andrade-Bellido, Raúl Jesús
K1 Hierbas - Toxicología
AB 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. Material and 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=0.04). 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=0.008 and p=0.021, respectively), had more re-exposure events to the culprit HDS (14% vs 3% vs 0%; p=0.026), and had more severe and fatal/liver transplantation outcome (21% vs 12% vs 13%; p=0.005). 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-transplant than DILI related to conventional drugs.
PB Elsevier
YR 2022
FD 2022
LK https://hdl.handle.net/10630/28964
UL https://hdl.handle.net/10630/28964
LA spa
NO Bessone F, García-Cortés M, Medina-Caliz I, Hernandez N, Parana R, Mendizabal M, Schinoni MI, Ridruejo E, Nunes V, Peralta M, Santos G, Anders M, Chiodi D, Tagle M, Montes P, Carrera E, Arrese M, Lizarzabal MI, Alvarez-Alvarez I, Caballano-Infantes E, Niu H, Pinazo J, Cabello MR, Lucena MI, Andrade RJ. Herbal and Dietary Supplements-Induced Liver Injury in Latin America: Experience From the LATINDILI Network. Clin Gastroenterol Hepatol. 2022 Mar;20(3):e548-e563. doi: 10.1016/j.cgh.2021.01.011.
NO The present study has been 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.
DS RIUMA. Repositorio Institucional de la Universidad de Málaga
RD 20 ene 2026