Hepatic veno-occlusive disease as a result of a traditional remedy: confirmation of toxic pyrrolizidine alkaloids as the cause, using an in vitro technique. Issue 9 (1st September 2002)

• Record Type: Journal Article
• Authors: Zuckerman, M; Steenkamp, V; Stewart, M J
• Is Part Of: Journal of clinical pathology. Volume 55:Issue 9(2002)
• Page Start: 676
• Page End: 679
• Publication Date: 2002-09-01
• Subjects: traditional remedy -- poisoning -- hepatotoxicity -- pyrrolizidine alkaloids; DAPI, 4, 6, diamino-2-phenylindole -- GC/MS, gas chromatography/mass spectrometry -- VOD, veno-occlusive disease; Pathology -- Periodicals; Pathology, Molecular -- Periodicals; 616.0705
• DOI: 10.1136/jcp.55.9.676
• Languages: English
• ISSNs: 0021-9746

Abstract

Abstract : Background/Aims: A child presented with hepatic veno-occlusive disease after having been administered a short course of treatment with a traditional herbal remedy. The child subsequently died. Postmortem liver histology confirmed the diagnosis. This study aimed to investigate the hypothesis that the herbal remedy was the cause of veno-occlusive disease. Methods: Extracts of the traditional remedy were analysed by colorimetry and gas chromatography/mass spectrometry. Cultured hepatocytes were treated with an extract of the plant material and examined for morphological changes. Results: The screening analyses indicated the presence of toxic pyrrolizidine alkaloids, which were later confirmed by gas chromatography/mass spectrometry. The cell studies indicated dose related toxicity, with necrosis at high concentrations and apoptosis and abnormalities of the cytoskeleton at lower concentrations. Conclusions: The simple screening techniques used allowed rapid confirmation of the presence of toxic pyrrolizidines in the remedy. The in vitro method confirmed the toxicity of herbal extracts to hepatocytes.