Hepatitis after germander (Teucrium chamaedrys) administration: another instance of herbal medicine hepatotoxicity.

OBJECTIVE

To show that germander (Teucrium chamaedrys), an herbal medicine used to facilitate weight loss, may be hepatotoxic and to delineate the nature of the injury.

DESIGN

Retrospective study.

SETTING

Liver units of several centers in the French Network of Pharmacovigilance.

PATIENTS

Seven patients who developed hepatitis after germander administration and who had no other cause of liver injury.

MEASUREMENTS

Clinical examination, liver function tests, various serologic tests, ultrasonography, and histologic study.

RESULTS

Hepatitis characterized by jaundice and a marked increase in serum aminotransferase levels occurred 3 to 18 weeks after germander administration. Liver biopsy specimens in three patients showed hepatocyte necrosis. After discontinuing treatment with germander, jaundice disappeared within 8 weeks and recovery was complete in 1.5 to 6 months. In three cases, germander readministration was followed by the prompt recurrence of hepatitis.

CONCLUSION

Germander may be hepatotoxic, which supports the view that herbal medicines are not always as safe as generally assumed.