Pillukat Mike H, Bester Carolin, Hensel Andreas, Lechtenberg Matthias, Petereit Frank, Beckebaum Susanne, Müller Klaus-Michael, Schmidt Hartmut H J
Department of Transplantation Medicine, University Hospital of Münster, Münster, Germany.
Institute of Pharmaceutical Biology and Phytochemistry, University of Münster, Münster, Germany.
J Ethnopharmacol. 2014 Aug 8;155(1):165-70. doi: 10.1016/j.jep.2014.05.015. Epub 2014 May 24.
ETNOPHARMACOLOGICAL RELEVANCE: The popularity of concentrated green tea extracts as dietary supplements for a wide range of applications is increasing due to their health-promoting effects attributed to the high amounts of catechins they contain. The most important of the green tea catechins is (-)-epigallocatechin-3-O-gallate (EGCG). While their beneficiary effects have been studied extensively, a small number of adverse events have been reported in the medical literature. Here we present a typical reversible course of severe hepatitis after green tea consumption.
The case study describes in a 63-year old woman during treatment with green tea-capsules upon recommendation of a cancer support group.
The histological finding was consistent with drug induced hepatitis, and other possible causes of hepatitis were excluded. According to the CIOMS/RUCAM score the causality was assessed as "probable". After discontinuation of medication, followed by extracorporal albumin dialysis, rapid and sustained recovery occurred. Pharmaceutically analysis (HPLC) of the green tea capsules did not give evidence for contaminants but revealed the two typical compounds of green tea, namely (-)-epigallocatechin-3-O-gallate (EGCG, 93.2%) and epicatechin (EC, 6.8%) at a very high dose level.
The present case highlights the fact that such concentrated herbal extracts from green tea may not be free of adverse effects under certain circumstances. There is still a lack of a uniform European Union-wide surveillance system for adverse drug reactions of herbal products. Therefore this case underlines the importance of public awareness in the potential risks in use of herbal products.
民族药理学相关性：浓缩绿茶提取物作为膳食补充剂在广泛应用中越来越受欢迎，因为其含有的大量儿茶素具有促进健康的作用。绿茶儿茶素中最重要的是（-）-表没食子儿茶素-3-O-没食子酸酯（EGCG）。虽然对其有益作用进行了广泛研究，但医学文献中也报道了少数不良事件。在此，我们呈现了一例饮用绿茶后典型的严重肝炎可逆病程。
该病例研究描述了一名63岁女性，在一个癌症支持小组的建议下服用绿茶胶囊进行治疗。
组织学检查结果与药物性肝炎一致，排除了其他可能的肝炎病因。根据CIOMS/RUCAM评分，因果关系被评估为“很可能”。停药后，接着进行体外白蛋白透析，患者迅速且持续康复。对绿茶胶囊的药物分析（高效液相色谱法）未发现污染物证据，但显示在非常高的剂量水平下含有绿茶的两种典型化合物，即（-）-表没食子儿茶素-3-O-没食子酸酯（EGCG，93.2%）和表儿茶素（EC，6.8%）。
本病例突出了这样一个事实，即在某些情况下，这种浓缩的绿茶草药提取物可能并非没有不良反应。欧盟范围内仍然缺乏针对草药产品药物不良反应的统一监测系统。因此，该病例强调了公众对使用草药产品潜在风险的认识的重要性。
