Fulminant hepatic failure associated with the use of black cohosh: A case report

@article{Lynch2006FulminantHF,
  title={Fulminant hepatic failure associated with the use of black cohosh: A case report},
  author={Christopher Lynch and Milan E. Folkers and William R. Hutson},
  journal={Liver Transplantation},
  year={2006},
  volume={12}
}
With data from the Women's Health Initiative indicating that estrogen plus progesterone are associated with an increased risk of cardiovascular events, many patients and practitioners are looking for alternative therapies to manage menopausal symptoms. One alternative is black cohosh, an herbal product used primarily to treat these symptoms. In recent years there have been several case reports associating this substance with hepatitis and fulminant hepatic failure. We present a case of a woman… 
Severe hepatitis associated with the use of black cohosh: a report of two cases and an advice for caution.
TLDR
The cases of two patients, one with submassive liver necrosis and the other with chronic hepatitis most likely related to the use of two different preparations containing black cohosh are reported, representing another advice for caution concerning this popular preparation of inconsistent therapeutic value.
Liver failure associated with the use of black cohosh for menopausal symptoms
TLDR
Physical examination revealed jaundice and mild ascites, but no evidence of hepatic encephalopathy or stigmata of chronic liver disease, and results of laboratory studies were consistent with acute hepatitis.
Black cohosh: a cause of abnormal postmenopausal liver function tests
  • D. Joy, J. Joy, P. Duane
  • Medicine
    Climacteric : the journal of the International Menopause Society
  • 2008
TLDR
This work presents two cases of liver toxicity related to Black cohosh and recommends close monitoring of women on this herbal preparation for postmenopausal symptoms.
Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh
TLDR
Liver injury following the use of black cohosh should be included in the list of differential diagnoses for chronic hepatitis with features mimicking autoimmune hepatitis.
Black Cohosh and Liver Toxicity: Is There a Relationship?
TLDR
It was concluded that the acute liver injury was caused by the use of black cohosh, and the United States Pharmacopeia recommendations that a cautionary warning about hepatotoxicity should be labeled on the drug package are agreed.
Hydroxycut hepatotoxicity: a case series and review of liver toxicity from herbal weight loss supplements.
TLDR
An increased effort to screen for and educate patients and physicians about supplement-associated hepatotoxicity is warranted.
Black cohosh, safety, and public awareness
  • K. Dunbar, S. Solga
  • Medicine
    Liver international : official journal of the International Association for the Study of the Liver
  • 2007
TLDR
The patient continued to have signs of subfulminant hepatic failure with worsening of her liver synthetic function and encephalopathy and received a liver transplant approximately 2:5 months after the onset of symptoms and had no recurrence of giant cell hepatitis or liver dysfunction after transplant.
Herbal hepatotoxicity: a case of difficult interpretation.
TLDR
This clinical case of a woman, who developed a mixed cholestatic/hepatocellular liver injury due to herbal products is presented to encourage the communication doctor/patient in phytotherapy area and physician knowledge about efficacy and side effects of herbal medicine to avoid delayed diagnosis.
Black Cohosh and Climacteric Symptoms: Growing Knowledge about the Efficacy and Safety
TLDR
Black cohosh shows great promise for relief of menopausal symptoms, primarly of vasomotor and possibly mood symptoms, with an overall positive safety profile of at least 6 months and likely longer, however, data from longer and in some cases more rigorous clinical trials are necessary to assess high efficacy and to substantiate safety.
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