title: Fulminant liver failure due to usnic acid for weight loss.
abstract: The use of complementary and alternative medicine (CAM) in developed countries has increased significantly over the years. Among the most popular are the weight loss supplements or "fat burners." Liver failure due to these popular remedies has been widely recognized. Usnic acid has been an ingredient of dietary supplements that cause liver failure. Its hepatotoxicity has not been recognized because it is usually mixed with other ingredients that are presumably hepatotoxic. We describe a case of a 28-yr-old woman who presented with fulminant liver failure requiring orthotopic liver transplantation, after taking pure usnic acid for weight loss. This is the first report on fulminant liver failure associated with the ingestion of pure usnic acid. A discussion about hepatotoxicity of the different compounds of dietary supplements is presented. This is a reminder for the clinicians about the potential side effects of CAM.
authors.affiliation: Division of Digestive Diseases, Department of Medicin,; Dumont-UCLA Liver Transplant Center, University of California, Los Angeles, California 90095-9302, USA.
authors.forename: Francisco A
authors.initials: FA
authors.lastname: Durazo
authors.forename: Charles
authors.initials: C
authors.lastname: Lassman
authors.forename: Steven H B
authors.initials: SH
authors.lastname: Han
authors.forename: Sammy
authors.initials: S
authors.lastname: Saab
authors.forename: Nancy P
authors.initials: NP
authors.lastname: Lee
authors.forename: Marvin
authors.initials: M
authors.lastname: Kawano
authors.forename: Bob
authors.initials: B
authors.lastname: Saggi
authors.forename: Sherilyn
authors.initials: S
authors.lastname: Gordon
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Farmer
authors.forename: Hasan
authors.initials: H
authors.lastname: Yersiz
authors.forename: R Leonard I
authors.initials: RL
authors.lastname: Goldstein
authors.forename: Mark
authors.initials: M
authors.lastname: Ghobrial
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Busuttil
mesh_terms: D000328:Adult; D001572:Benzofurans / Q000008:administration & dosage / Q000009:adverse effects*; D019587:Dietary Supplements / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017093:Liver Failure / Q000139:chemically induced* / Q000503:physiopathology / Q000601:surgery*; D016031:Liver Transplantation; D009765:Obesity / Q000188:drug therapy; D018570:Risk Assessment; D015431:Weight Loss / Q000187:drug effects
chemical_list: D001572:Benzofurans; C073339:usnic acid