Resumen

ALVAREZ UMANA, Silvia Vanessa; SOTO CERDAS, Jahaira Vanessa; QUIROS QUIROS, Víctor Daniel  y  GONZALEZ SAENZ, Marcela. Hepatotoxicidad por sustancias de origen botánico. Med. leg. Costa Rica [online]. 2016, vol.33, n.1, pp.85-95. ISSN 2215-5287.

here is a growing interest in prevention of diseases and improvement of health. That is why nutritional supplements have been developed and perceived by people as harmless, but plants produce chemical substances that can lead to liver damage. The supplements used for bodybuilding and weight reduction constituted the most common natural products accounting for hepatotoxicity in last times. The diagnosis of liver injury associated to natural products should be done in a systematic way and should include information about the first use of the substance, the treatment period and latency. Commonly, the clinic is an acute condition with nonspecific symptoms. The measurement of levels of alanine aminotransferase (ALT), alkaline phosphatase (PA) and relationship between these variables serve as criteria of liver injury. With cessation of the agent involved, clinical signs usually yield and there is a marked decrease in the liver biomarkers levels. Positive results for no intentional reexposure is the gold standard to confirm hepatotoxicity to natural substances. There are no specific histologic findings for liver damage, so biopsy cannot be used for diagnosis. In order to objectify the adverse effects we use the CIOMS/RUCAM Scale (Council for International Organizations of Medical Sciences/ Roussel Uclaf Causality Assesment Method). In addition to the potential for direct hepatotoxicity, some of the herbs may have interactions with certain prescription medications, so physicians should ask for using natural products and prevention of concomitant use. There is no antidote for the treatment of hepatotoxicity for herbs, so the suspension of using these products is the only therapeutic management.

Palabras clave : hepatotoxicity; hepatic injury; nutritional supplements; natural products; natural sustances; botanical origin.

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