The DOI matches its Crossref record; 2 of the 2 references it cites were found in a registry or an index.
Drug-Induced Hepatocellular Injury Due to Herbal Supplement Ashwagandha
Abstract
A 39-year-old female presented with a one-week history of jaundice and nausea after taking an over-the-counter herbal supplement containing ashwagandha root extract. Initial investigations revealed a hepatocellular pattern of liver enzyme abnormality with jaundice. Investigations, including viral serology, liver specific autoantibodies and an ultrasound scan of the abdomen, were unremarkable. Liver biopsy showed an acute cholestatic hepatitis with confluent necrosis but no features of chronicity. These histopathological findings differ to that of a previously reported case. Review of recent literature revealed that some clinical features and the time course of liver injury were similar to previous reports of ashwagandha drug-induced liver injury (DILI). The patient received treatment with ursodeoxycholic acid. We compare this case to previous reported cases of ashwagandha DILI and discuss the biochemical and histopathological features of ashwagandha DILI, therapeutic strategies and the importance of recognising herbal supplements as a possible cause of DILI.
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Reports of ashwagandha-induced liver injury have been notable in medical literature since 2017.
“Reports of ashwagandha-induced liver injury have been notable in medical literature since 2017.”
From Ashwagandha-induced liver injury—A case series from India and literature review (2023) · cites this paper as [20]
Since the first report, a total of 14 cases (excluding the current series) of ashwagandha-induced liver injury are available.
“Since the first report, a total of 14 cases (excluding the current series) of ashwagandha-induced liver injury are available.17–26”
From Ashwagandha-induced liver injury—A case series from India and literature review (2023) · cites this paper as [20]
Citations
Cites
Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network
Navarro, V. J., Barnhart, H., Bonkovsky, H. L., Davern, T., Fontana, R. J., Grant, L., Reddy, R. K., Seeff, L. B., Serrano, J., Sherker, A. H., et al. (2014) · Hepatology · doi:10.1002/hep.27317 · Cited by 418
Björnsson, H. K., Björnsson, E. S., Avula, B., Khan, I. A., Jonasson, J. G., Ghabril, M., Hayashi, P. H., & Navarro, V. (2020) · Liver International · doi:10.1111/liv.14393 · Cited by 125
Flagged first, then by citations
Research works printed but not linked: 5
- 10.1080/19390211.2017.1284970 · DOI · Paper page
- LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases. 2012–. Ashwagandha. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548536/
- 10.1053/j.gastro.2015.03.006 · DOI · Paper page
- 10.1016/S0168-8278(01)00092-7 · DOI
- 10.1016/j.jhep.2018.05.013 · DOI
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Ashwagandha-induced liver injury—A case series from India and literature review
Philips, C. A., Valsan, A., Theruvath, A. H., Ravindran, R., Oommen, T. T., Rajesh, S., Bishnu, S., Augustine, P., & India, O. B. O. T. L. R. C. (2023) · Hepatology Communications · doi:10.1097/hc9.0000000000000270 · Cited by 62
Metadata
- Authors
- Ireland, P. J., Hardy, T., Burt, A. D., & Donnelly, M. C.
- Affiliations
- Freeman Hospital (GB)
- Royal Victoria Infirmary (GB)
- Corresponding author
- Donnelly, Mhairi C
- Venue
- Journal of the Royal College of Physicians of Edinburgh
- Publisher
- SAGE Publications
- Published
- 2021-12
- Volume
- 51
- Issue
- 4
- Pages
- 363-366
- ISSN
- 1478-2715 (ISSN-L)
- 2042-8189
- OpenAlex
- W4200127092
- Cited by
- 27
- References
- 2
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 7 · 2023: 4 · 2022: 3
- FWCI
- 2.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of the Royal College of Physicians of Edinburgh (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medical Research Council (MR/N005872/1)
- 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
- drug-induced liver injury, Withania somnifera, herbal supplements, hepatocyte injury, cholestatic hepatitis, jaundice, liver enzyme abnormalities, ursodeoxycholic acid, liver biopsy histology, hepatotoxicity
- MeSH terms
- Adult, Female, Carcinoma, Hepatocellular, Humans, Liver Neoplasms, Plant Extracts, Dietary Supplements
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