Philips Cyriac Abby, Paramaguru Rajaguru, Augustine Philip
The Liver Unit, Cochin Gastroenterology Group, Ernakulam Medical Centre, Kochi, Kerala, India.
Department of Pathology, PVS Memorial Hospital Ltd, Kochi, Kerala, India.
BMJ Case Rep. 2018 Jun 29;2018:bcr-2018-225590. doi: 10.1136/bcr-2018-225590.
Ayurveda Bhasma is a metallic-mineral preparation homogenised with herbal juices or decoctions and modified with heat treatment to apparently detoxify the heavy metals. It is widely recommended for the treatment of many disease conditions by practitioners of complementary and alternative medicine in the absence of good quality clinical trial evidence on its safety and efficacy. Heavy metal-induced liver injury is widely reported in the literature, and heavy metal adulteration of non-Bhasma-related Ayurveda and herbal products has been well described. We report a patient who developed severe liver injury requiring listing for liver transplantation for improved survival, after consumption of Bhasma for dyspepsia. This case describes the first documented case and toxicology analysis of Ayurveda Bhasma associated with severe drug-induced liver injury. Physicians must be alert regarding patient's use of supposedly safe Ayurveda Bhasma that may promote acute severe liver injury in the absence of other known aetiologies.
阿育吠陀药粉是一种金属矿物质制剂，与草药汁或煎剂均匀混合，并经过热处理以明显去除重金属毒性。在缺乏关于其安全性和有效性的高质量临床试验证据的情况下，补充和替代医学从业者广泛推荐使用它来治疗多种疾病。文献中广泛报道了重金属引起的肝损伤，并且非药粉类阿育吠陀和草药产品的重金属掺假情况也有详细描述。我们报告了一名患者，在因消化不良服用药粉后，出现了严重肝损伤，需要列入肝移植名单以提高生存率。本病例描述了首例有记录的与严重药物性肝损伤相关的阿育吠陀药粉病例及毒理学分析。医生必须警惕患者使用本应安全的阿育吠陀药粉，在没有其他已知病因的情况下，该药粉可能会引发急性严重肝损伤。
