Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Sep 8, 2015; 7(19): 2189-2193
Published online Sep 8, 2015. doi: 10.4254/wjh.v7.i19.2189
Herbal medicine-related hepatotoxicity
Evangelos Stournaras, Konstantinos Tziomalos
Evangelos Stournaras, Konstantinos Tziomalos, First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54636 Thessaloniki, Greece
Author contributions: Stournaras E drafted the paper; Tziomalos K revised the draft critically for important intellectual content.
Conflict-of-interest statement: We have no conflict of interest to declare.
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: Konstantinos Tziomalos, MD, PhD, First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Kiriakidi 1, 54636 Thessaloniki, Greece. ktziomalos@yahoo.com
Telephone: +30-2310-994621 Fax: +30-2310-994773
Received: May 15, 2015
Peer-review started: May 15, 2015
First decision: July 15, 2015
Revised: July 22, 2015
Accepted: August 20, 2015
Article in press: August 21, 2015
Published online: September 8, 2015
Processing time: 117 Days and 14.5 Hours
Abstract

Herbal medicine products represent a common therapeutic approach in the East and are gaining increasing popularity in Western countries. They are unjustifiably considered to be side-effect free; on the contrary, severe toxicity, including catastrophic hepatic injury has been reported in association with their use. Vigilance is required from both physicians and the general public. Physicians should always suspect herbal medicines when evaluating a patient with unexplained liver injury. Regulation standards for herbal products need to be reconsidered, so that the efficacy and safety of these products have been clearly demonstrated before they enter the markets.

Keywords: Herbal medicines; Liver transplantation; Cholestasis

Core tip: Herbal medicine products represent a common therapeutic approach in the East and are gaining increasing popularity in Western countries. They are unjustifiably considered to be side-effect free; on the contrary, severe toxicity, including catastrophic hepatic injury has been reported in association with their use. Vigilance is required from both physicians and the general public. Physicians should always suspect herbal medicines when evaluating a patient with unexplained liver injury. Regulation standards for herbal products need to be reconsidered, so that the efficacy and safety of these products have been clearly demonstrated before they enter the markets.