Acute Hepatitis Induced by Greater Celandine (Chelidonium majus)

We report on two cases of acute liver injury along with the intake of Greater Celandine (Chelidonium majus), a well-known herbal remedy frequently used for irritable bowel syndrome. All other possible causes of acute liver damage were excluded in both patients. In one patient, cholestatic hepatitis recurred rapidly after involuntary re-exposition. Both patients fully recovered after the withdrawal of Greater Celandine. The two cases add to the existing database about the potential hepatotoxicity of drugs containing Greater Celandine and raise the question whether the approval of this drug should be re-evaluated in the light of lacking evidence for a therapeutic benefit.

[1]  Sanford H. Levy The risk-benefit profile of commonly used herbal therapies. , 2002, Annals of internal medicine.

[2]  E. Ernst Safety concerns about kava , 2002, The Lancet.

[3]  M. M. van den Heuvel,et al.  [Acute hepatitis after use of a herbal preparation with greater celandine (Chelidonium majus)]. , 2002, Nederlands tijdschrift voor geneeskunde.

[4]  M. Kraft,et al.  [Fulminant liver failure after administration of the herbal antidepressant Kava-Kava]. , 2001, Deutsche medizinische Wochenschrift.

[5]  E. Walters,et al.  Long-Term Trends in the Use of Complementary and Alternative Medical Therapies in the United States , 2001, Annals of Internal Medicine.

[6]  R. Andrade,et al.  Comparison of two clinical scales for causality assessment in hepatotoxicity , 2001, Hepatology.

[7]  F. Stickel,et al.  The efficacy and safety of comfrey , 2000, Public Health Nutrition.

[8]  D. Schuppan,et al.  Acute hepatitis induced by greater celandine (Chelidonium majus). , 1999, Gastroenterology.

[9]  C. Monnerjahn,et al.  Chelidonium majus: a rare reason for severe hepatotoxic reaction , 1998, Pharmacoepidemiology and drug safety.

[10]  R. Victorino,et al.  Development and validation of a clinical scale for the diagnosis of drug‐induced hepatitis , 1997, Hepatology.

[11]  C. McLean,et al.  Chinese herbal medicine, fulminant hepatitis, and liver transplantation. , 1996, The American journal of gastroenterology.

[12]  E. Bosisio,et al.  Pharmacological activities of Chelidonium majus L. (Papaveraceae). , 1996, Pharmacological research.

[13]  A. Nahrstedt,et al.  The effect of Chelidonium majus herb extract on choleresis in the isolated perfused rat liver. , 1995, Planta medica.

[14]  D. Larrey,et al.  Hepatitis after Germander (Teucrium chamaedrys) Administration: Another Instance of Herbal Medicine Hepatotoxicity , 1992, Annals of Internal Medicine.

[15]  P. Ridker,et al.  Hepatic venocclusive disease associated with the consumption of pyrrolizidine-containing dietary supplements. , 1985, Gastroenterology.

[16]  E. Ernst The RiskBenefit Profile of Commonly Used Herbal Therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava , 2002, Annals of Internal Medicine.