HEPATITIS AFTER GERMANDER (TEUCRIUM-CHAMAEDRYS) ADMINISTRATION - ANOTHER INSTANCE OF HERBAL MEDICINE HEPATOTOXICITY

Objective: To show that germander (Teucrium chamaedrys), an herbal medicine used to facilitate weight loss, may be hepatotoxic and to delineate the nature of the injury. Design: Retrospective study. Setting: Liver units of several centers in the French Network of Pharmacovigilance. Patients: Seven patients who developed hepatitis after germander administration and who had no other cause of liver injury. Measurements: Clinical examination, liver function tests, various serologic tests, ultrasonography, and histologic study. Results: Hepatitis characterized by jaundice and a marked increase in serum aminotransferase levels occurred 3 to 18 weeks after germander administration. Liver biopsy specimens in three patients showed hepatocyte necrosis. After discontinuing treatment with germander, jaundice disappeared within 8 weeks and recovery was complete in 1.5 to 6 months. In three cases, germander readministration was followed by the prompt recurrence of hepatitis. Conclusion: Germander may be hepatotoxic, which supports the view that herbal medicines are not always as safe as generally assumed.