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阿育吠陀疗法在一名14岁女孩身上引发了严重酒精性肝炎和非肝硬化性门静脉高压症。

Ayurvedic treatment induced severe alcoholic hepatitis and non-cirrhotic portal hypertension in a 14-year-old girl.

作者信息

Philips Cyriac Abby, Ahamed Rizwan, Abduljaleel Jinsha K, Rajesh Sasidharan, Theruvath Arif Hussain, Raveendran Resmi, Augustine Philip

机构信息

Clinical and Translational Hepatology & Monarch Liver Laboratory, The Liver Institute, Center of Excellence in GI Sciences, Rajagiri Hospital, Aluva, Kerala, India.

Gastroenterology & Advanced GI Endoscopy, Center of Excellence in GI Sciences, Rajagiri Hospital, Aluva, Kerala, India.

出版信息

Oxf Med Case Reports. 2022 Oct 22;2022(10):omac113. doi: 10.1093/omcr/omac113. eCollection 2022 Oct.

DOI:10.1093/omcr/omac113
PMID:36299672
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9589464/
Abstract

We report a novel and as yet undescribed clinical scenario in a young girl with liver failure, in whom, the liver histopathology was suggestive of alcoholic hepatitis in the background of hepatoportal sclerosis and incomplete septal cirrhosis. An extensive clinical and investigational evaluation revealed chronic consumption of multiple Ayurvedic herbal medications for seizure disease. Six months after stopping herbal medicines, the repeat liver biopsy demonstrated resolution of alcohol-related changes but persistence of classical features of non-cirrhotic portal hypertension. Analysis of the retrieved agents, including state of the art chemical and toxicology analysis, using gas chromatography and mass spectroscopy methods demonstrated multiple organic and inorganic toxins associated with acute alcohol and arsenic poisoning related hepatoportal sclerosis/incomplete septal cirrhosis in the young girl.

摘要

我们报告了一名患有肝衰竭的年轻女孩的一种新颖且尚未描述的临床情况，其肝脏组织病理学提示在肝门脉硬化和不完全间隔性肝硬化背景下存在酒精性肝炎。广泛的临床和调查评估显示，该女孩长期服用多种用于治疗癫痫疾病的阿育吠陀草药。停用草药六个月后，再次进行肝脏活检显示与酒精相关的变化有所缓解，但非肝硬化性门静脉高压的典型特征依然存在。使用气相色谱和质谱法对所提取的药物进行分析，包括最先进的化学和毒理学分析，结果表明该年轻女孩体内存在多种与急性酒精和砷中毒相关的有机和无机毒素，这些毒素与肝门脉硬化/不完全间隔性肝硬化有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3274/9589464/c19a40bafd3e/omac113f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3274/9589464/ef58f5cf5f7f/omac113f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3274/9589464/c19a40bafd3e/omac113f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3274/9589464/ef58f5cf5f7f/omac113f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3274/9589464/c19a40bafd3e/omac113f2.jpg

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本文引用的文献

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2
The Contents of Herbal and Dietary Supplements Implicated in Liver Injury in the United States Are Frequently Mislabeled.在美国，与肝损伤相关的草药和膳食补充剂经常被错误标注。
Hepatol Commun. 2019 Apr 3;3(6):792-794. doi: 10.1002/hep4.1346. eCollection 2019 Jun.
3
Homeopathy-medicine induced severe alcoholic hepatitis.
顺势疗法药物诱发的严重酒精性肝炎。
BMJ Case Rep. 2019 May 28;12(5):e229627. doi: 10.1136/bcr-2019-229627.
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Severe Alcoholic Hepatitis in a Teetotaler.一名滴酒不沾者患严重酒精性肝炎。
Am J Gastroenterol. 2018 Aug;113(8):1260-1261. doi: 10.1038/s41395-018-0154-0. Epub 2018 Jun 11.
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Toxic metals in ayurvedic preparations from a public health lead poisoning cluster investigation.基于公共卫生铅中毒聚集性调查的阿育吠陀制剂中的有毒金属
Int J Occup Environ Health. 2017 Jul;23(3):187-192. doi: 10.1080/10773525.2018.1447880. Epub 2018 Mar 12.
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Clinical outcomes, histopathological patterns, and chemical analysis of Ayurveda and herbal medicine associated with severe liver injury-A single-center experience from southern India.阿育吠陀医学和草药与严重肝损伤相关的临床结局、组织病理学模式及化学分析——来自印度南部的单中心经验
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