Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2016; 22(45): 10071-10076
Published online Dec 7, 2016. doi: 10.3748/wjg.v22.i45.10071
Dangerous dietary supplements: Garcinia cambogia-associated hepatic failure requiring transplantation
Keri E Lunsford, Adam S Bodzin, Diego C Reino, Hanlin L Wang, Ronald W Busuttil
Keri E Lunsford, Adam S Bodzin, Diego C Reino, Ronald W Busuttil, The Pfleger Liver Institute, The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA 90095, United States
Keri E Lunsford, J.C Walter Jr. Center for Transplantation, Sherrie and Alan Conover Center for Liver Disease and Transplantation, Center for Transplantation Immunobiology, Houston Methodist Hospital and Research Institute, Houston, TX 77030, United States
Hanlin L Wang, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA 90095, United States
Author contributions: Lunsford KE and Busuttil RW designed the report; Lunsford KE, Bodzin AS and Reino DC collected and analyzed the patient’s data; Wang HL performed histologic analysis; Lunsford KE wrote the paper, Lunsford KE, Bodzin AS, Reino DC and Busuttil RW performed critical review and revision of the manuscript.
Institutional review board statement: This is a case report, which, per the policies of the Institutional Review Board at the University of California, Los Angeles, is exempt from review.
Informed consent statement: The patient presented in this case report gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: The authors report no conflicting interests (including but not limited to commercial, personal, political, intellectual or religious interests) relating to the present manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Keri E Lunsford, MD, PhD, J.C Walter Jr. Center for Transplantation, Sherrie and Alan Conover Center for Liver Disease and Transplantation, Center for Transplantation Immunobiology, Houston Methodist Hospital and Research Institute, 6670 Bertner Ave., Suite R7-416, Houston, TX 77030, United States. klunsford@houstonmethodist.org
Telephone: +1-713-4412038 Fax: +1-713-4417439
Received: April 27, 2016
Peer-review started: April 27, 2016
First decision: June 20, 2016
Revised: July 6, 2016
Accepted: August 5, 2016
Article in press: August 5, 2016
Published online: December 7, 2016
Processing time: 223 Days and 11.7 Hours
Abstract

Commercial dietary supplements are marketed as a panacea for the morbidly obese seeking sustainable weight-loss. Unfortunately, many claims cited by supplements are unsupported and inadequately regulated. Most concerning, however, are the associated harmful side effects, often unrecognized by consumers. Garcinia cambogia extract and Garcinia cambogia containing products are some of the most popular dietary supplements currently marketed for weight loss. Here, we report the first known case of fulminant hepatic failure associated with this dietary supplement. One active ingredient in this supplement is hydroxycitric acid, an active ingredient also found in weight-loss supplements banned by the Food and Drug Administration in 2009 for hepatotoxicity. Heightened awareness of the dangers of dietary supplements such as Garcinia cambogia is imperative to prevent hepatoxicity and potential fulminant hepatic failure in additional patients.

Keywords: Dietary supplements; Fulminant hepatic failure; Drug-induced liver injury; Liver transplantation; Hyroxycitric acid; Weight-loss supplements

Core tip: The current regulatory practice for over-the-counter dietary supplements in addition to celebrity endorsements of these products unfounded claims has resulted in a significant increase in the use of dietary supplements for weight loss. Unfortunately, several such products have previously been demonstrated to be serious health risks. Here we present one of the first known cases of fulminant hepatic failure associated with one such popular weight loss supplement, Garcinia cambogia.