TY  - JOUR
A1  - Teschke, Rolf
A1  - Schwarzenböck, Alexander
A1  - Schmidt-Taenzer, Wolfgang
A1  - Wolff, Albrecht Titus
A1  - Hennermann, Karl-Heinz
T1  - Herb induced liver injury presumably caused by black cohosh: A survey of initially purported cases and herbal quality specifications
T2  - Annals of Hepatology
N2  - Herb induced liver injury (HILI) is a particular challenge that also applies to purported cases presumably caused by black cohosh (BC), an herb commonly used to treat menopausal symptoms. We analyzed and reviewed all published case reports and spontaneous reports of initially alleged BC hepatotoxicity regarding quality of case details and causality assessments. Shortcomings of data quality were more evident in spontaneous reports of regulatory agencies compared to published case reports, but assessments with the scale of CIOMS (Council for the International Organizations of Sciences) or its updated version revealed lack of causality for BC in all cases. The applied causality methods are structured, quantitative, and liver specific with clear preference over an ad hoc causality method or the liver unspecific Naranjo scale. Reviewing the case data and the reports dealing with quality specifications of herbal BC products, there is general lack of analysis with respect to authentication of BC in the BC products used by the patients. However, in one single regulatory study, there was a problem of BC authentication in the analysed BC products, and other reports addressed the question of impurities and adulterants in a few BC products. It is concluded that the use of BC may not exert an overt hepatotoxicity risk, but quality problems in a few BC products were evident that require additional regulatory quality specifications.
KW  - Herb induced liver injury
KW  - Drug induced liver injury
KW  - Hepatotoxicity
KW  - Herbal hepatotoxicity
KW  - Black cohosh induced liver injury
KW  - Black cohosh
KW  - Actaea cimicifuga
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/76570
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-765706
SN  - 1665-2681
VL  - 10
IS  - 3
SP  - 249
EP  - 259
PB  - Mexican Association of Hepatology
CY  - México
ER  -