Copyright
©2013 Baishideng Publishing Group Co.
World J Gastroenterol. May 21, 2013; 19(19): 2864-2882
Published online May 21, 2013. doi: 10.3748/wjg.v19.i19.2864
Published online May 21, 2013. doi: 10.3748/wjg.v19.i19.2864
Items to be assessed | Information obtained | ||
Yes | No | Partial | |
Brand name with batch number and expiration date | □ | □ | □ |
Indication of herbal use | □ | □ | □ |
Dates of symptoms leading to herbal treatment | □ | □ | □ |
Daily dose | □ | □ | □ |
Application form of herbal product | □ | □ | □ |
Exact date of herb start | □ | □ | □ |
Exact date of herb end | □ | □ | □ |
Accurate dates of emerging new symptoms after herb start in chronological order | □ | □ | □ |
Accurate date of initially increased liver values | □ | □ | □ |
Time frame of challenge | □ | □ | □ |
Time frame of latency period | □ | □ | □ |
Time frame of dechallenge | □ | □ | □ |
Verification of temporal association | □ | □ | □ |
Exclusion of temporal association | □ | □ | □ |
Gender, age, body weight, height, BMI | □ | □ | □ |
Ethnicity, profession | □ | □ | □ |
Past medical history and actual assessment regarding preexisting general diseases | □ | □ | □ |
Past medical history and actual assessment regarding preexisting liver diseases | □ | □ | □ |
Risk factors such as age and alcohol | □ | □ | □ |
Quantification of alcohol and drug use | □ | □ | □ |
Comedicated synthetic drugs, herbal drugs, herbal and other dietary supplements with all details of product, daily dose, exact dates of start and end of use, indication | □ | □ | □ |
ALT value initially including exact date and normal range | □ | □ | □ |
ALT values during dechallenge at least on days 8 and 30, and later on, with exact dates | □ | □ | □ |
ALT values during dechallenge to exclude a second peak, with exact dates | □ | □ | □ |
ALT normalization with exact date and actual value | □ | □ | □ |
ALP value initially including exact date and normal range | □ | □ | □ |
ALP values during dechallenge up to 180 d, and later on, with exact dates | □ | □ | □ |
ALP values during dechallenge to exclude a second peak, with exact dates | □ | □ | □ |
ALP normalization with exact date and actual value | □ | □ | □ |
AST value initially including normal range | □ | □ | □ |
Laboratory criteria for definition of hepatotoxicity | □ | □ | □ |
Laboratory criteria for injury pattern | □ | □ | □ |
Liver and biliary tract imaging including hepatobiliary sonography, CT, MRT, MRC | □ | □ | □ |
Color Doppler sonography of liver vessels | □ | □ | □ |
Unintended reexposure | □ | □ | □ |
Known hepatotoxicity caused by the herb | □ | □ | □ |
Consideration and exclusion of other possible causes | □ | □ | □ |
Hepatitis A | □ | □ | □ |
Anti-HAV-IgM | |||
Hepatitis B | □ | □ | □ |
HBsAg, anti-HBc-IgM, HBV-DNA | |||
Hepatitis C | □ | □ | □ |
Anti-HCV, HCV-RNA | |||
Hepatitis E | □ | □ | □ |
Anti-HEV-IgM, anti-HEV-IgG, HEV-RNA | |||
CMV | □ | □ | □ |
CMV-PCR, titer change for anti-CMV-IgM and anti-CMV-IgG | |||
EBV | □ | □ | □ |
EBV-PCR, titer change for anti-EBV-IgM and anti-EBV-IgG | |||
HSV | □ | □ | □ |
HSV-PCR, titer change for anti-HSV-IgM and anti-HSV- IgG | |||
VZV | □ | □ | □ |
VZV-PCR, titer change for anti-VZV-IgM and anti-VZV-IgG | |||
Other virus infections | □ | □ | □ |
Specific serology of Adenovirus, Coxsackie-B-virus, Echovirus, Measles virus, Rubella virus, Flavivirus, Arenavirus, Filovirus, Parvovirus, HIV, and others | |||
Other infectious diseases | □ | □ | □ |
Specific assessment of bacteria, fungi, parasites, worms, and others | |||
AIH type I | □ | □ | □ |
Gamma globulins, ANA, SMA, AAA, SLA/LP, anti-LSP, anti-ASGPR | |||
AIH type II | □ | □ | □ |
Gamma globulins, anti-LKM-1 (CYP 2D6), anti-LKM-2 (CYP 2C9), anti-LKM-3 | |||
PBC | □ | □ | □ |
AMA, anti-PDH-E2 | |||
PSC | □ | □ | □ |
p-ANCA, MRC | |||
AIC | □ | □ | □ |
ANA, SMA | |||
Overlap syndromes | □ | □ | □ |
See AIH, PBC, PSC, and AIC | |||
NASH | □ | □ | □ |
BMI, insulin resistance, hepatomegaly, echogenicity of the liver | |||
ALD | □ | □ | □ |
Patient’s history, clinical and laboratory assessment, sonography | |||
DILI | □ | □ | □ |
Patient’s history, clinical and laboratory assessment, sonography, use of the CIOMS scale | |||
Cocaine, ecstasy and other amphetamines | □ | □ | □ |
Toxin screening | |||
Rare intoxications | □ | □ | |
Toxin screening for household and occupational toxins | |||
Hereditary hemochromatosis | □ | □ | □ |
Serum ferritin, total iron-binding capacity, genotyping for C2824 and H63D mutation, hepatic iron content | |||
Wilson’s disease | □ | □ | □ |
Copper excretion (24 h urine), ceruloplasmin in serum, free copper in serum, Coombs-negative hemolytic anemia, hepatic copper content, Kayser-Fleischer-Ring, neurologic-psychiatric work-up, genotyping | |||
Porphyria | □ | □ | □ |
Porphobilinogen in urine, total porphyrines in urine | |||
α1-Antitrypsin deficiency | □ | □ | □ |
α1-Antitrypsin in serum | |||
Biliary diseases | □ | □ | □ |
Clinical and laboratory assessment, hepatobiliary sonography, endosonography, CT, MRT, MRC | |||
Pancreatic diseases | □ | □ | □ |
Clinical and laboratory assessment, sonography, CT, MRT | |||
Celiac disease | □ | □ | □ |
TTG antibodies, endomysium antibodies, duodenal biopsy | |||
Anorexia nervosa | □ | □ | □ |
Clinical context | |||
Parenteral nutrition | □ | □ | □ |
Clinical context | |||
Cardiopulmonary diseases with shock liver (cardiac hepatopathy, ischemic hepatitis) | □ | □ | □ |
Cardiopulmonary assessment of congestive heart disease, myocardial infarction, cardiomyopathy, cardiac valvular dysfunction, pulmonary embolism, pericardial diseases, arrhythmia, hemorrhagic shock, and various other conditions | |||
Addison’s disease | |||
Plasma cortisol | □ | □ | □ |
Thyroid diseases | |||
TSH basal, T4, T3 | □ | □ | □ |
Grand mal seizures | |||
Clinical context of epileptic seizure (duration > 30 min) | □ | □ | □ |
Heat stroke | |||
Shock, hyperthermia | □ | □ | □ |
Polytrauma | |||
Shock, liver injury | □ | □ | □ |
Systemic diseases | |||
Specific assessment of M. Boeck, amyloidosis, lymphoma, other malignant tumors, sepsis and others | □ | □ | □ |
Other diseases | |||
Clinical context | □ | □ | □ |
- Citation: Teschke R, Frenzel C, Schulze J, Eickhoff A. Herbal hepatotoxicity: Challenges and pitfalls of causality assessment methods. World J Gastroenterol 2013; 19(19): 2864-2882
- URL: https://www.wjgnet.com/1007-9327/full/v19/i19/2864.htm
- DOI: https://dx.doi.org/10.3748/wjg.v19.i19.2864