title: Adulteration of South African traditional herbal remedies.
abstract: Traditional herbal remedies are used as alternative medicine by a large proportion of people worldwide. Herbals are generally perceived as safe, harmless, and free from side effects, but there have been reports of adulteration of Asian herbal remedies with Western pharmaceuticals, a practice that has not hitherto been observed in Africa. The authors present 2 cases from South Africa in which herbal remedies, consumed by patients admitted to hospital, were found to be adulterated with commercially available Western medicines. The adulterants were identified using high-performance liquid chromatography with a photodiode array detector and gas chromatography-mass spectrometry. The authors alert clinicians to the fact that adulteration of herbal remedies may become more common and should be considered, especially in cases where the symptoms are confusing in light of the history.
authors.affiliation: Department of Chemical Pathology, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Tracy
authors.initials: T
authors.lastname: Snyman
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stewart
authors.forename: Alida
authors.initials: A
authors.lastname: Grove
authors.forename: Vanessa
authors.initials: V
authors.lastname: Steenkamp
mesh_terms: D000140:Acidosis, Lactic / Q000175:diagnosis / Q000378:metabolism; D000328:Adult; D056486:Chemical and Drug Induced Liver Injury; D002675:Child, Preschool; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D004008:Diclofenac / Q000009:adverse effects / Q000032:analysis; D004340:Drug Contamination; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods; D029001:Herbal Medicine; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000378:metabolism; D016488:Medicine, African Traditional; D015742:Propofol / Q000009:adverse effects / Q000032:analysis; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism; D012996:Solutions / Q000008:administration & dosage / Q000009:adverse effects / Q000032:analysis; D014293:Trimethadione / Q000009:adverse effects / Q000032:analysis; D014597:Uterine Rupture / Q000139:chemically induced / Q000175:diagnosis / Q000378:metabolism
chemical_list: D012996:Solutions; D004008:Diclofenac; D014293:Trimethadione; D015742:Propofol