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Hepatitis after Germander (Teucrium chamaedrys) Administration: Another Instance of Herbal Medicine Hepatotoxicity

Dominique Larrey, MD, PhD.; Thierry Vial, MD; Arnaud Pauwels, MD; Anne Castot, MD; Michel Biour, MD; Martine David, PhD.; and Henri Michel, MD.
[+] Article, Author, and Disclosure Information

Requests for Reprints: Dominique Larrey, MD, Service des Maladies de l'Appareil Digestif, Hôpital Saint-Eloi, 34059 Montpellier, France.

Current Author Addresses: Drs. Larrey and Michel: Service des Maladies de l'Appareil Digestif, Hôpital Saint-Eloi, 34059 Montpellier, France.

Dr. Vial: Service de Pharmacotoxicovigilance, Hôpital Edouard Herriot, 69000 Lyon, France.

Dr. Pauwels: Service d'Hépatogastroentérologie Hôpital Saint-Antoine, 75012 Paris, France.

Drs. Castot and David: Centre de Pharmacovigilance, Hôpital Fernand Widal, 75010 Paris, France.

Dr. Biour: Centre de Pharmacovigilance, Hôpital Saint-Antoine, 75012 Paris, France.

©1992 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1992;117(2):129-132. doi:10.7326/0003-4819-117-2-129
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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.





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