title: Mesenteric phlebosclerosis associated with long-term oral intake of geniposide, an ingredient of herbal medicine.
abstract: BACKGROUND
  Idiopathic mesenteric phlebosclerosis (IMP) is a rare disease, characterised by thickening of the wall of the right hemicolon with calcification of mesenteric veins. However, the aetiology remains unknown.
  
  
  OBJECTIVE
  To investigate the possible association of herbal medicines with IMP.
  
  
  METHODS
  The clinical data of four of our own patients were collected. Furthermore, we searched for previous reports about similar patients with detailed descriptions of herbal prescriptions that they had taken. We compared herbal ingredients to identify the toxic agent as a possible aetiological factor.
  
  
  RESULTS
  Clinical data on a total of 25 patients were summarised. Mean age was 61.8 years and there was female predominance (6 men and 19 women). The used Kampo prescription, the number of cases, and the mean duration of use were as follows: kamisyoyosan in 12 cases for 12.8 years, inshin-iseihaito in 5 cases for 13.4 years, orengedokuto in 4 cases for 14.3 years, inchinkoto in 1 case for 20 years, kamikihitou in 1 case for 19 years, seijobofuto in 1 case for 10 years and gorinsan in 1 case for an unknown duration. Only one ingredient, sansisi, was common to the herbal medicines of all 25 patients. This crude drug called geniposide in English is a major constituent of the Gardenia fruits.
  
  
  CONCLUSIONS
  The long-term use of geniposide in herbal medicines appears to be associated with mesenteric phlebosclerosis.
authors: Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama, Japan. vintage1995gp@yahoo.co.jp
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authors: Hiramatsu
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authors: Sakata
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mesh_terms: D000368:Aged; D001706:Biopsy; D004365:Drugs, Chinese Herbal / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D039823:Iridoids / Q000009:adverse effects*; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D008642:Mesenteric Veins / Q000473:pathology*; D008875:Middle Aged; D010946:Plants, Medicinal / Q000009:adverse effects*; D012598:Sclerosis / Q000139:chemically induced; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D004365:Drugs, Chinese Herbal; D039823:Iridoids; C007835:geniposide