1.
Herbal Supplements Association with Reversible Cerebral Vasoconstriction Syndrome: A Case Report.
Costa, I, Mendonça, MD, Cruz E Silva, V, Calado, S, Viana-Baptista, M
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2017;(3):673-676
Abstract
BACKGROUND Reversible cerebral vasoconstriction syndrome (RCVS) is a clinico-radiologic syndrome characterized by thunderclap headache and reversible multifocal arterial constrictions that resolves within 3 months. RCVS can be either spontaneous or related to a trigger; vasoactive drugs including over-the-counter medicine are common culprits. Nevertheless, there are sparse data on the association of herbal supplements in the genesis of unexplained RCVS. METHODS We describe a case of RCVS with a temporal association with the consumption of a diet pill composed of green tea, L-carnitine, and conjugated linoleic acid. We reviewed the literature describing RCVS cases associated with consumption of herbal supplements or plants. RESULTS A 50-year-old black woman presented at the emergency room with a thunderclap headache less than 1 week after beginning a new herbal supplement with weight loss purpose. Angiographic study revealed multiple arterial constriction of virtually all intracranial territories that were reversed 28 days later. The patient was discharged with minimal symptoms. From our review, we identified 5 previous reports of herbal product-related triggers. CONCLUSIONS Different factors can trigger RCVS. Besides our case, at least 5 other nutraceutical products were described to be associated with the disorders, 3 of them in patients without any other clear cause. Clinicians should be aware of the possible role of herbal supplements in RCVS, and their use should be systematically assessed in large RCVS cohorts to clarify this association.
2.
[A case of acute encephalopathy due to datura seed poisoning].
Kuwabara, T, Ohshima, K
Rinsho shinkeigaku = Clinical neurology. 2004;(6):355-8
Abstract
A 83 year-old-man presented with a stuporous state. He ingested datura seeds approximately 1.5 hour before the onset of the symptom. On arrival at our emergency clinic 2 hours and 40 minutes after the ingestion, he was semi-comatose with intermittent tonic convulsive seizures. The pupils were fully-dilated and unreactive, and salivation was decreased. He showed hypohidrosis and exaggerated deep tendon reflexes with positive Babinski's sign. His body temperature was 37.6 degrees C, and blood pressure was 167/99 mmHg. After gastrolavage and administration of charcoal and cathartics, his pupil became reactive to light, and he became alert gradually. His consciousness became clear 24 hours after seed ingestion and discharged with no residual neurological signs.
3.
[Acute hepatitis due to ingestion of Teucrium chamaedrys infusions].
Pérez Alvarez, J, Sáez-Royuela, F, Gento Peña, E, López Morante, A, Velasco Osés, A, Martín Lorente, J
Gastroenterologia y hepatologia. 2001;(5):240-3
Abstract
Herbal remedies, used for many years for therapeutic purposes, have traditionally been considered safe and effective. Herbal medicine toxicity has been infrequently reported in Spain. We present two cases of acute hepatitis after ingestion of herbal infusions over a period of several months. Among the plants consumed was Teucrium chamaedrys (germander), which has been associated with several cases of hepatotoxicity, mainly in France. After ruling out other causes of hepatitis, we consider that Teucrium chamaedrys provoked the disease. One patient presented acute, cholestatic hepatitis and another presented mixed (hepatocellular and cholestatic) hepatitis. In both patients, the disease was resolved after discontinuing the intake of the herbal teas. We believe that herbal medicine toxicity may be increasing due to the growing consumption of these products. Finally, we emphasize the need to rule out the intake of herbal remedies in patients whose liver tests present abnormalities.