title: Hepatotoxicity of NONI juice: report of two cases.
abstract: NONI juice (Morinda citrifolia) is an increasingly popular wellness drink claimed to be beneficial for many illnesses. No overt toxicity has been reported to date. We present two cases of novel hepatotoxicity of NONI juice. Causality of liver injury by NONI juice was asses-sed. Routine laboratory tests and transjugular or percutaneous liver biopsy were performed. The first patient underwent successful liver transplantation while the second patient recovered spontaneously after cessation of NONI juice. A 29-year-old man with previous toxic hepatitis associated with small doses of paracetamol developed sub-acute hepatic failure following consumption of 1.5 L NONI juice over 3 wk necessitating urgent liver transplantation. A 62-year-old woman without evidence of previous liver disease developed an episode of self-limited acute hepatitis following consumption of 2 L NONI juice for over 3 mo. The most likely hepatotoxic components of Morinda citrifolia were anthraquinones. Physicians should be aware of potential hepatotoxicity of NONI juice.
authors.affiliation: Department of Internal Medicine, Medical University Graz, Austria.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Stadlbauer
authors.forename: Peter
authors.initials: P
authors.lastname: Fickert
authors.forename: Carolin
authors.initials: C
authors.lastname: Lackner
authors.forename: Jutta
authors.initials: J
authors.lastname: Schmerlaib
authors.forename: Peter
authors.initials: P
authors.lastname: Krisper
authors.forename: Michael
authors.initials: M
authors.lastname: Trauner
authors.forename: Rudolf E
authors.initials: RE
authors.lastname: Stauber
mesh_terms: D000328:Adult; D001628:Beverages / Q000633:toxicity; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000473:pathology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D032066:Morinda / Q000633:toxicity*; D028321:Plant Preparations / Q000633:toxicity
chemical_list: D028321:Plant Preparations