title: Hepatic injury due to traditional aqueous extracts of kava root in New Caledonia.
abstract: Traditional aqueous kava extracts were the most probable cause of hepatitis in two patients presenting with markedly elevated transaminases and hyperbilirubinaemia. A consequent survey of 27 heavy kava drinkers in New Caledonia showed elevated gamma glutamyl transferase in 23/27 and minimally elevated transaminases in 8/27. We conclude that not only commercially available, but also traditionally prepared kava extracts may rarely cause liver injury. The increased activity of gamma glutamyl transferase in heavy kava consumers in the presence of normal or minimally elevated transaminases is probably not a sign of liver injury, but rather reflects an induction of CYP450 enzymes.
authors.affiliation: Department of Clinical Pharmacology, University of Bern, Switzerland. stefan.russmann@ikp.unibe.ch
authors.forename: Stefan
authors.initials: S
authors.lastname: Russmann
authors.forename: Yann
authors.initials: Y
authors.lastname: Barguil
authors.forename: Pierre
authors.initials: P
authors.lastname: Cabalion
authors.forename: Marina
authors.initials: M
authors.lastname: Kritsanida
authors.forename: Daniel
authors.initials: D
authors.lastname: Duhet
authors.forename: Bernhard H
authors.initials: BH
authors.lastname: Lauterburg
mesh_terms: D000328:Adult; D056486:Chemical and Drug Induced Liver Injury / Q000201:enzymology / Q000209:etiology*; D005260:Female; D006801:Humans; D020901:Kava / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy / Q000009:adverse effects*; D010936:Plant Extracts / Q000009:adverse effects; D000637:Transaminases / Q000097:blood; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D010936:Plant Extracts; D005723:gamma-Glutamyltransferase; D000637:Transaminases