title: Adverse Effects of Plant Food Supplements and Plants Consumed as Food: Results from the Poisons Centres-Based PlantLIBRA Study.
abstract: Plant food supplements (PFS) are products of increasing popularity and wide-spread distribution. Nevertheless, information about their risks is limited. To fill this gap, a poisons centres-based study was performed as part of the EU project PlantLIBRA. Multicentre retrospective review of data from selected European and Brazilian poisons centres, involving human cases of adverse effects due to plants consumed as food or as ingredients of food supplements recorded between 2006 and 2010. Ten poisons centres provided a total of 75 cases. In 57 cases (76%) a PFS was involved; in 18 (24%) a plant was ingested as food. The 10 most frequently reported plants were Valeriana officinalis, Camellia sinensis, Paullinia cupana, Melissa officinalis, Passiflora incarnata, Mentha piperita, Glycyrrhiza glabra, Ilex paraguariensis, Panax ginseng, and Citrus aurantium. The most frequently observed clinical effects were neurotoxicity and gastro-intestinal symptoms. Most cases showed a benign clinical course; however, five cases were severe. PFS-related adverse effects seem to be relatively infrequent issues for poisons centres. Most cases showed mild symptoms. Nevertheless, the occurrence of some severe adverse effects and the increasing popularity of PFS require continuous active surveillance, and further research is warranted. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland.
authors.forename: Saskia
authors.identifier: http://orcid.org/0000-0001-7102-1341
authors.initials: S
authors.lastname: Lüde
authors.affiliation: Pavia Poison Center and National Toxicology Information Centre-Toxicology Unit IRCCS Maugeri Foundation and University of Pavia, Pavia, Italy.
authors.forename: Sarah
authors.initials: S
authors.lastname: Vecchio
authors.affiliation: Institut de Veille Sanitaire, Saint-Maurice, France.
authors.forename: Sandra
authors.initials: S
authors.lastname: Sinno-Tellier
authors.affiliation: Nutrivigilance, Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail, Maisons-Alfort, France.
authors.forename: Aymeric
authors.initials: A
authors.lastname: Dopter
authors.affiliation: Poison Information Centre, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Harriet
authors.initials: H
authors.lastname: Mustonen
authors.affiliation: National Poison Control Centre, Military Medical Academy, Belgrade, Serbia.
authors.forename: Slavica
authors.initials: S
authors.lastname: Vucinic
authors.affiliation: Swedish Poisons Information Centre, Stockholm, Sweden.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Jonsson
authors.affiliation: GIZ-Nord Poisons Center Göttingen, Göttingen, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Müller
authors.affiliation: Poison Control Centre of Sao Paulo, Hospital Municipal Dr Arthur Ribeiro de Saboya, Sao Paulo, Brazil.
authors.forename: Ligia
authors.initials: L
authors.lastname: Veras Gimenez Fruchtengarten
authors.affiliation: Austrian Poisons Information Centre, Vienna, Austria.
authors.forename: Karl
authors.initials: K
authors.lastname: Hruby
authors.affiliation: University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: De Souza Nascimento
authors.affiliation: Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Di Lorenzo
authors.affiliation: Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Restani
authors.affiliation: National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland.
authors.forename: Hugo
authors.initials: H
authors.lastname: Kupferschmidt
authors.affiliation: National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland.|Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, Zurich, Switzerland.|Division of Clinical Pharmacology and Toxicology, Department of Internal Medicine, Ente Ospedaliero Cantonale, Lugano, Switzerland.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ceschi
mesh_terms: D019587:Dietary Supplements / Q000009:adverse effects*; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D028321:Plant Preparations / Q000009:adverse effects*; D011039:Poison Control Centers; D012189:Retrospective Studies
chemical_list: D028321:Plant Preparations
keywords: adverse reactions; botanicals; nutritional supplements; plants; poisons centres; toxicity