The Annals Visit the PharmaCE website!
home help contact us subscription past issues search current issue
QUICK SEARCH:   [advanced]


     


Published Online, 28 August 2007, www.theannals.com, DOI 10.1345/aph.1K132.
 The Annals of Pharmacotherapy: Vol. 41, No. 10, pp. 1740-1743. DOI 10.1345/aph.1K132
© 2007 Harvey Whitney Books Company.
This Article
Right arrow Résumé Freely available
Right arrow Extracto Freely available
Right arrow Full Text
Right arrow PDF
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Articles Ahead of Print
Right arrow [Order Reprint]
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bottenberg, M. M
Right arrow Articles by Habib, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bottenberg, M. M
Right arrow Articles by Habib, S.

Oral Aloe Vera-Induced Hepatitis

Michelle M Bottenberg, PharmD

Internal Medicine Clinical Pharmacist, Veterans Affairs Medical Center, Des Moines, IA; Assistant Professor of Pharmacy Practice, College of Pharmacy, Drake University, Des Moines

Geoffrey C Wall, PharmD BCPS CGP

Internal Medicine Clinical Pharmacist, Iowa Methodist Medical Center, Des Moines; Associate Professor of Pharmacy Practice, College of Pharmacy, Drake University

Roger L Harvey, DO

Infectious Diseases Physician, Iowa Health Physicians, Des Moines; Iowa Methodist Medical Center

Shahid Habib, MD

Medical Director, Center for Liver Disease Iowa Health Physicians, Des Moines

Reprints: Dr. Bottenberg, College of Pharmacy and Health Sciences, Drake University, 2507 University Ave., Des Moines, IA 50311, fax 515/699-5882, michelle.bottenberg{at}drake.edu

OBJECTIVE: To report a case of possible oral aloe vera-induced hepatitis.

CASE SUMMARY: A 73-year-old female was admitted to the hospital for acute hepatitis. Extensive laboratory testing did not reveal the cause of the patient's disease. She was asked multiple times whether she was taking any home medications, which she initially denied. It was only after an extensive medication history done by a clinical pharmacist that the patient admitted to using oral aloe vera capsules for constipation. Upon discontinuation of the oral aloe vera, liver markers of hepatotoxicity returned to normal levels.

DISCUSSION: Herbal medications pose an increasing problem in patient safety, as the different types of these products and the number of patients who use them continue to grow. In the US, these products are not subject to the same regulatory scrutiny as prescription medications; thus, safety information can be difficult to obtain. In particular, hepatic toxicity due to herbal agents is poorly described in the medical literature. Aloe vera, often used topically for minor burns, can also be used orally as a laxative or an "anti-aging" agent. According to the Naranjo probability scale, the hepatotoxicity in this case was possibly related to ingestion of oral aloe vera. Additionally, using the Roussel Uclaf Causality Assessment Method for determining drug hepatotoxicity, the patient's symptoms were scored as probably caused by oral aloe vera. The more conservative designation was used in our report.

CONCLUSIONS: With the widespread use of oral aloe vera and other herbal products, clinicians faced with a case of acute hepatitis that is not readily diagnosed should question patients about herbal use.

Key Words: aloe vera, liver, toxicity

Published Online, August 28, 2007. www.theannals.com, DOI 10.1345/aph.1K132




homecopy help contact us subscription past issues search current issue
Copyright © 2007 by Harvey Whitney Books Company.