Hepatitis after germander (Teucrium chamaedrys) administration: another instance of herbal medicine hepatotoxicity.
OBJECTIVE
To show that germander (Teucrium chamaedrys), an herbal medicine used to facilitate weight loss, may be hepatotoxic and to delineate the nature of the injury.


METHODS
Retrospective study.


METHODS
Liver units of several centers in the French Network of Pharmacovigilance.


METHODS
Seven patients who developed hepatitis after germander administration and who had no other cause of liver injury.


METHODS
Clinical examination, liver function tests, various serologic tests, ultrasonography, and histologic study.


RESULTS
Hepatitis characterized by jaundice and a marked increase in serum aminotransferase levels occurred 3 to 18 weeks after germander administration. Liver biopsy specimens in three patients showed hepatocyte necrosis. After discontinuing treatment with germander, jaundice disappeared within 8 weeks and recovery was complete in 1.5 to 6 months. In three cases, germander readministration was followed by the prompt recurrence of hepatitis.


CONCLUSIONS
Germander may be hepatotoxic, which supports the view that herbal medicines are not always as safe as generally assumed.
Larrey
D
D
Service des Maladies de l'Appareil Digestif, Hôpital Saint-Eloi, Montpellier, France.
Vial
T
T
Pauwels
A
A
Castot
A
A
Biour
M
M
David
M
M
Michel
H
H
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001628:Beverages / Q000009:adverse effects; D002214:Capsules; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy; D010946:Plants, Medicinal
D002214:Capsules