Original Contribution
The American Journal of Gastroenterology (2000) 95, 3634–3637; doi:10.1111/j.1572-0241.2000.03386.x
Cascara sagrada-induced intrahepatic cholestasis causing portal hypertension: case report and review of herbal hepatotoxicity
Abdul Nadir MD1,2, Dorothy Reddy1,2 and David H Van Thiel MD, FACG1,2
- 1Division of Gastroenterology, Texas Tech University Health Science Center, Lubbock, Texas, USA
- 2Loyola University, Chicago, Illinois, USA
Correspondence: Abdul Nadir, MD, 43-63, 161st Street, 2nd floor, Flushing, NY 11358
Received 20 October 1998; Revised 0000; Accepted 23 March 1999.
Abstract
Herbal medicines are gaining widespread popularity. Much of the public believes that botanical herbs are both harmless and useful for the treatment of a variety of symptoms. This belief stands in contrast with the fact that many herbal therapies have been shown to be toxic. In the present case report, cascara sagrada (CS) has been associated with the development of cholestatic hepatitis, complicated by portal hypertension. CS is a mixture of ingredients, among which is anthracene glycoside—an herbal agent that previously has been associated with chronic hepatitis. The liver injury in the case herein reported is believed to be related to either anthracene glycoside or one of the other constituents of CS.
