Masayuki Adachi, MD; Hidetsugu Saito, MD, PhD; Hisashi Kobayashi, MD; Yoshinori Horie, MD, PhD; Shinzo Kato, MD, PhD; Masahiro Yoshioka, MD, PhD; Hiromasa Ishii, MD, PhD
Adachi M, Saito H, Kobayashi H, Horie Y, Kato S, Yoshioka M, et al. Hepatic Injury in 12 Patients Taking the Herbal Weight Loss Aids Chaso or Onshido. Ann Intern Med. 2003;139:488-492. doi: 10.7326/0003-4819-139-6-200309160-00012
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Published: Ann Intern Med. 2003;139(6):488-492.
The Chinese herbal dietary supplements Chaso and Onshido are marketed for weight loss in Japan. The safety of these weight loss aids is unknown.
To describe patients who developed liver injury while taking Chaso or Onshido.
Keio University Hospital, Tokyo, Japan, and other hospitals in Japan.
6 patients who took Chaso and 6 patients who took Onshido before presenting with liver injury.
Pathologic, clinical, and laboratory evaluations and chemical analysis of the herbal weight loss aids.
All 12 patients developed acute liver injury characterized by a marked increase in serum liver chemistry values (mean alanine aminotransferase level, 1978 U/L [range, 283 to 4074 U/L]) after ingesting these products. Two patients developed fulminant hepatic failure: 1 patient required liver transplantation, and the other patient died. N-nitroso-fenfluramine, a variant of the appetite-depressant drug fenfluramine, was present in these products.
The use of the weight loss aids Chaso and Onshido may be associated with acute liver injury. N-nitroso-fenfluramine is a possible hepatotoxic ingredient.
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Emergency Medicine, Gastroenterology/Hepatology, Liver Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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