Fanconi's syndrome, interstitial fibrosis and renal failure by aristolochic acid in Chinese herbs.
Aristolochic acid-associated nephropathy (AAN) has been identified as a separate entity of progressive tubulo-interstitial nephropathy. Its characteristic pathological findings, including hypocellular interstitial fibrosis, intimal thickening of interlobular and afferent arterioles with glomeruli sparing or mild sclerosis, have been identified. Many cases of AAN in adults have been reported in Taiwan as well as throughout the world, but it has seldom been described in children. We report on a 10-year-old boy who presented with severe anemia, Fanconi's syndrome, and progressive renal failure. Renal biopsy revealed typical findings of AAN. Aristolochic acids I and II were identified from a Chinese herb mixture ingested by the boy. AAN was diagnosed after other etiologies had been excluded. The case demonstrates the hazards of Chinese herbs with regard to children's health in Taiwan and suggests that more attention should be paid to this issue.
Hong
Yin-Tai
YT
Division of Immunology and Nephrology, Department of Pediatrics, Taichung Veterans' General Hospital, 160, Sec. 3, Chung-Kang Road, Taichung 407, Taiwan.
Fu
Lin-Shien
LS
Chung
Lin-Huei
LH
Hung
Shien-Chung
SC
Huang
Yi-Ting
YT
Chi
Chin-Shiang
CS
D034341:Aristolochic Acids / Q000009:adverse effects*; D002648:Child; D004365:Drugs, Chinese Herbal / Q000009:adverse effects*; D005198:Fanconi Syndrome / Q000139:chemically induced*; D005355:Fibrosis; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008297:Male; D009395:Nephritis, Interstitial / Q000139:chemically induced*; D051437:Renal Insufficiency / Q000139:chemically induced*
D034341:Aristolochic Acids; D004365:Drugs, Chinese Herbal