Orthotopic liver transplantation and hereditary hemorrhagic telangiectasia: do hepatic vascular malformations relapse? A long term follow up study on two patients

Le résumé fourni par la source

It is traditional to boil Ganoderma lucidum for ingestion without involving additional preparation. Ready-made products of Ganoderma lucidum either in form of powder or tablets are now available for general consumption. These different formulations of products usually required addition of other ingredients, which can be potentially toxic to the liver. For our patient, she initially took Ganoderma lucidum by boiling the herb for one year. The liver toxicity occurred 1 month after she started to take a ready-made powder formulation of Ganoderma lucidum. The cause of the liver toxicity was likely due to the toxic effect of the powder formulation of Ganoderma lucidum because of the following reasons: (1) The liver derangement started after the change of the formulation of Ganoderma lucidum; (2) The liver biochemistry showed gradual and continuous improvement upon withdrawal of the offending drug; (3) The features of the liver biopsy were most compatible with drug-induced liver damage; and (4) All the common possible causes of the liver derangement were excluded. To our knowledge, this is the first reported case of liver toxicity due to the intake of powder form of Ganoderma lucidum. The liver toxicity is most likely to be due to the ingredients of the powder formulation since the addition of other plants or ingredients in the preparation of Chinese herbal medicines is very common. However, we were unable to identify the additional substances. But other possibilities, such as an inadvertent change in the dose of Ganoderma lucidum associated with the change in formulation and different bioavailability of the new formulation cannot be ruled out.

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