J Korean Med Sci.  2010 Mar;25(3):492-495. 10.3346/jkms.2010.25.3.492.

Aloe-induced Toxic Hepatitis

• Yang HN
• Kim DJ
• Kim YM
• Kim BH
• Sohn KM
• Choi MJ
• Choi YH

• KMID: 1778051
• DOI: http://doi.org/10.3346/jkms.2010.25.3.492

Abstract

Aloe has been widely used in phytomedicine. Phytomedicine describes aloe as a herb which has anti-inflammatory, anti-proliferative, anti-aging effects. In recent years several cases of aloe-induced hepatotoxicity were reported. But its pharmacokinetics and toxicity are poorly described in the literature. Here we report three cases with aloe-induced toxic hepatitis. A 57-yr-old woman, a 62-yr-old woman and a 55-yr-old woman were admitted to the hospital for acute hepatitis. They had taken aloe preparation for months. Their clinical manifestation, laboratory findings and histologic findings met diagnostic criteria (RUCAM scale) of toxic hepatitis. Upon discontinuation of the oral aloe preparations, liver enzymes returned to normal level. Aloe should be considered as a causative agent in hepatotoxicity.

Keyword

Aloe; Hepatitis, Toxic

MeSH Terms

Aloe/*adverse effects
Animals
Dietary Supplements/adverse effects
*Drug-Induced Liver Injury/enzymology/pathology/physiopathology
Female
Humans
Middle Aged
Phytotherapy/adverse effects
Plant Extracts/adverse effects
Plant Extracts

Figure

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  Fig. 1 Preparation of aloe which the patient had taken. (A) Container bottle and tablets. (B) Packs of aloe extract.

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  Fig. 2 Histopathological findings of the liver. (A) The portal area and lobular area show inflammatory cell infiltration (H&E, ×100). (B) The acidophilic body and ballooning cell change are noted (H&E, ×200).

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  Fig. 3 Case 1. Upon discontinuation of the oral aloe preparation, liver enzymes returned to normal level.

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  Fig. 4 Case 2. Upon discontinuation of the oral aloe preparation, liver enzymes returned to normal level. After re-challenge (arrow), liver enzymes go up again.

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  Fig. 5 Case 3. Upon discontinuation of the oral aloe preparation, liver enzymes returned to normal level.

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