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Cited by 60Drug-Induced Hepatotoxicity and ProtectionComplementary and Alternative Medicine StudiesPlant Toxicity and Pharmacological Properties

The DOI matches its Crossref record; 3 of the 3 references it cites were found in a registry or an index.

Herbal and Dietary Supplements-Induced Liver Injury in Latin America: Experience From the LATINDILI Network

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Bessone, Fernando, García-Cortés, Miren, Medina-Caliz, Inmaculada, Hernandez, Nelia, Parana, Raymundo, Mendizabal, Manuel, Schinoni, Maria I., Ridruejo, Ezequiel, Nunes, Vinicius, Peralta, Mirta, Santos, Genario, Anders, Margarita, Chiodi, Daniela, Tagle, Martin, Montes, Pedro, Carrera, Enrique, Arrese, Marco, Lizarzabal, M. Isabel, Alvarez-Alvarez, Ismael, Caballano-Infantes, Estefania, Niu, Hao, Pinazo, Jose, Cabello, Maria R., Lucena, M. Isabel, Andrade, Raúl J.·2022·Clinical Gastroenterology and Hepatology
DOI 10.1016/j.cgh.2021.01.011
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Abstract

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. 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 = .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 = .008 and p = .021, respectively), had more re-exposure events to the culprit HDS (14% vs 3% vs 0%; p = .026), and had more severe and fatal/liver transplantation outcomes (21% vs 12% vs 13%; p = .005). Compared to other DILI cohorts, less HDS hepatotoxicity cases in Latin Ameri…

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Crossref · 10.1016/j.cgh.2021.01.011

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  • Herbal drugs and dietary supplements are a major growing concern for liver injury, liver failure, and death or liver transplantation globally.

    “Herbal drugs and dietary supplements are a major growing concern for liver injury, liver failure, and death or liver transplantation globally.3–6”

    From Ashwagandha-induced liver injury—A case series from India and literature review (2023) · cites this paper as [4]

  • Liver-specific causality scales do not capture the complexity of HDS-induced liver injury and are therefore not suitable for attributing causality in that context, because HDS products are frequently multi-ingredient and the toxic compound is often not identified or mislabelled.

    “However, it is important to emphasize that the liver‐specific scales do not capture the complexity of HDS‐induced liver injury and are therefore not suitable for attributing causality in this context, as these products are frequently multi‐ingredient and the toxic compound is often not identified or mislabelled.”

    From Methods for causality assessment of idiosyncratic drug‐induced liver injury (2025) · cites this paper as [5]

  • Multiple studies from Asia, Europe, and Latin-America have shown that liver injury caused by HMs/HDS is more severe than that caused by other drugs, with a higher risk of death or requirement of liver transplantation.

    “Multiple studies from Asia, Europe, and Latin-America have shown that liver injury caused by HMs/HDS is more severe than that caused by other drugs, with a higher risk of death or requirement of liver transplantation [120,124,134].”

    From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [124]

  • In the US, HDS accounts for approximately 20% of DILI cases, ranking second, and 8-16% in Europe and Latin America.

    “In the US, HDS accounts for approximately 20% of DILI cases, ranking second [123], and 8-16% in Europe and Latin America [3,124,125].”

    From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [124]

Citations

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Metadata

Authors
Bessone, F., García-Cortés, M., Medina-Caliz, I., Hernandez, N., Parana, R., Mendizabal, M., Schinoni, M. I., Ridruejo, E., Nunes, V., Peralta, M., Santos, G., Anders, M., Chiodi, D., Tagle, M., Montes, P., Carrera, E., Arrese, M., Lizarzabal, M. I., Alvarez-Alvarez, I., Caballano-Infantes, E., Niu, H., Pinazo, J., Cabello, M. R., Lucena, M. I., & Andrade, R. J.
Affiliations
  • National University of Rosario (AR)
  • Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (AR)
  • Hospital Muñiz (AR)
  • Hospital Alemán (AR)
  • Hospital de Clínicas (UY)
  • Hospital de Especialidades Eugenio Espejo (EC)
  • Pontificia Universidad Católica de Chile (CL)
  • Instituto de Investigación Biomédica de Málaga (ES)
  • Centro de Investigación Biomédica en Red (ES)
Corresponding author
  • Bessone, Fernando
  • Lucena, M. Isabel
ORCID
Venue
Clinical Gastroenterology and Hepatology
Publisher
Elsevier BV
Published
2022-03
Volume
20
Issue
3
Pages
e548-e563
ISSN
1542-3565 (ISSN-L)
DOI
10.1016/j.cgh.2021.01.011
OpenAlex
W3119737001
Cited by
60
References
3
Citations by year
2026: 13 · 2025: 9 · 2024: 16 · 2023: 9 · 2022: 9
FWCI
5.61
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Gastroenterology and Hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • Repositorio Institucional de la Universidad de Málaga (University of Málaga) (submittedVersion, cc-by-nc-nd)
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
  • Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Plant Toxicity and Pharmacological Properties
Keywords
herbal and dietary supplements, drug-induced liver injury, hepatotoxicity, Latin America, Camellia sinensis, Herbalife, Garcinia cambogia, weight loss supplements, acute liver failure, hepatocyte injury, jaundice, re-exposure, anabolic steroids, liver transplantation
MeSH terms
Female, Humans, Latin America, Male, Middle Aged, Liver Transplantation, Dietary Supplements, Plant Preparations, Chemical and Drug Induced Liver Injury

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