Abstract: The belief that approaching nature can enhance well-being, widely promoted by mass media, is widespread. People explore parks and forests searching for wild herbs, berries and mushrooms that could be used as food or medicines,
thinking that all things natural are healthy and harmless while picking up toxic species or encountering a snake is not so infrequent. To point out the Italian cases concerning these natural poisons, all cases handled between 2001 and 2005
by Poison Control Centre of Milan, the leading toxicological centre in Italy, have been reviewed. Regarding plants, 4432 records were collected; the patients most frequently involved were children that had picked poisonous species at home, at school or in other public places, but the most serious cases were related to wild plants used by adults for health enhancement: three deaths were recorded. Among 4289 calls concerning mushrooms several life-threatening cases, 6 transplants and 9 deaths were recorded. Eventually, 2072 records connected to snake bites were collected, among them at least 1061 were related to Vipera spp.: three patients died. These accidents can lead to severe or lethal poisonings that, requiring intensive medical cares and antidotes, have also a social and economic cost to the National
Health Service. A public information campaign should be promoted to make people more aware of the risks of these events and of the detrimental consequences that this could have. Some cases of poisonings have arisen due to incorrect information conveyed through radio, television, press and the Internet; we highlight the need for better control on the content of messages diffused through mass media.
Abstract: PURPOSE: To review the current literature on suspected green tea-related hepatic reactions and to describe two new cases reported within the framework of the Italian surveillance system of natural health products. RESULTS: A literature search of publication between 1999 and October 2008 retrieved 34 cases of hepatitis. Histological examination of the liver revealed inflammatory reactions, cholestasis, occasional steatosis, and necrosis. A positive dechallenge was reported in 29 cases. There was one reported death. A positive rechallenge occurred in seven cases (20%). In the two new cases, the causality assessment was judged as "possible" according to the RUCAM score. CONCLUSIONS: Our analysis of the published case reports suggests a causal association between green tea and liver damage. The hepatotoxicity is probably due to (-)-epigallocatechin gallate or its metabolites which, under particular conditions related to the patient's metabolism, can induce oxidative stress in the liver. In a few cases, toxicity related to concomitant medications could also be involved.
Abstract: ETHNOPHARMACOLOGICAL RELEVANCE: Folk medicine is a rich source of useful therapeutic tools. Nevertheless, use of medicinal plants can have unwanted, negative effects. By means of the description of an adverse reaction to a herbal remedy, we highlight the need for better efficacy-toxicity studies on these products. AIM OF THE STUDY: To report a case of possible Chelidonium majus L. (Greater celandine)-induced hepatitis and evaluate the past published cases. MATERIALS AND METHODS: We outlined the main features of hepatitis associated with use of Chelidonium majus by providing a review of cases reported and analysing in detail a new one. RESULTS: Several cases of acute hepatitis related to Greater celandine consumption were found in the literature. The assessment for causality using Naranjo probability scale showed a probable relationship between the liver injury and the consumption of Chelidonium majus in the case we described. CONCLUSIONS: Our case, along with the other ones reported in the literature, increases the concern about the safety of oral use of Chelidonium majus. Plants used in traditional medicine are not necessarily harmless. Customers and prescribers should be aware of this, especially when a herbal drug is used with therapeutic purposes in absence of reliable studies of clinical efficacy and benefit-risk assessment.
