Kumana C R, Ng M, Lin H J, Ko W, Wu P C, Todd D
Gut. 1985 Jan;26(1):101-4. doi: 10.1136/gut.26.1.101.
Four young Chinese women took daily doses of an unidentified 'Indian' herbal tea as treatment for psoriasis. Three (one of whom died), developed ascites, hepatomegaly and biochemical abnormalities within 19-45 days. The fourth patient discontinued herbal tea after 21 days when she developed a skin rash. Two patients had portal hypertension, while all had liver histology showing features of veno-occlusive disease. Pyrrolizidine alkaloids were identified spectrophotometrically in the brewed tea, and in the chopped leaves of the herbal mixture; the mean dose in the tea prepared for consumption being 12 mg/day of alkaloid base and 18 mg/day of N-oxide. The mean cumulative dose of alkaloids (base + N-oxide) before onset of symptoms (three patients), was estimated to be 18 mg/kg. In the asymptomatic patient with histological liver disease only, the corresponding dose was 15 mg/kg. These cases thus provide some measure of pyrrolizidine alkaloid toxicity in adults.
四名年轻中国女性每日饮用一种成分不明的“印度”草药茶来治疗牛皮癣。其中三人（一人死亡）在19至45天内出现腹水、肝肿大和生化异常。第四名患者在饮用21天后出现皮疹，随后停止饮用草药茶。两名患者患有门静脉高压，而所有人的肝脏组织学检查均显示有肝小静脉闭塞病的特征。通过分光光度法在冲泡的茶以及草药混合物的切碎叶片中鉴定出了吡咯里西啶生物碱；供饮用的茶中生物碱碱的平均剂量为12毫克/天，N-氧化物的平均剂量为18毫克/天。在出现症状之前（三名患者），生物碱（碱+N-氧化物）的平均累积剂量估计为18毫克/千克。仅在患有肝脏组织学疾病的无症状患者中，相应剂量为15毫克/千克。因此，这些病例提供了一定程度的成人吡咯里西啶生物碱毒性情况。
