The Cause of Chinese Herbs Nephropathy Tragic Paradigm

The subacute course of the disease and its clear association with a slimming diet prescribed by a medical team alone strongly suggests a toxic etiology. The fact that renal disease developed only in patients treated between 1990 and 1992, a slimming pill, whose content was modified in 1990 by replacing the previously innocuous mixture of extracts of Fucus, Laminaria and dust of the pancreas, two of Chinese herbs, Stephania tetrandra and Magnolia officinalis, about the search for the culprit that Chinese herbs. The phytochemical analysis of the capsules quickly eliminated the possibility of adulteration of toxic compounds known. In contrast to the alkaloid derived from Stephania tetrandra could not be identified, suggesting that this herb can be replaced by another, more toxic plants. This hypothesis was supported by Pui-Hay, but have shown the presence of Aristolochiafangchi in a pile of Chinese herbs imported into Belgium, a conclusion later confirmed by Van Haelen et al. Aristolochic acid could then be accused of drugs: is a substance with potent mutagenicity also nephrotoxic. Do not forget that the name of aristolochic acid includes a large number of different molecules but similar. However, the fact that Chinese herbs imported from both lots were used for the same purpose, without apparent side effects increases the possibility of a synergistic effect of herbs with some of the toxic compounds included in the slimming cure. His relations with other kidney diseases This unfortunate series of observations raises important questions. The analogy between China and the Balkan endemic nephropathy (BEN) could provide a clue to the cause of the illness of the latter. Both sides the same conditions unusual histological picture of severe interstitial fibrosis with focal lesions paucicellular due to vascular endothelial cells' swelling. Both lead to the transformation of cellular atypia and malignant urothelium. And finally, have a tubular proteinuria confirms a primary tubular damage. This similarity lends support not only to a toxic origin of Ben, but also by a common etiologic factor, aristolochic acid. Ben's role in the latter compound had been previously thought, but not fully investigated. However, the two diseases differ in the pace of change: a few months to several years in China for several years in BEN. This difference may be related to the amount of acid ingestion artistolochic. After discontinuation of the toxic diet pills, CHN follows an inexorable course, even if the initial serum creatinine normal. Nitrosourea-induced interstitial nephritis may follow a similar pattern. Consideration of the two diseases may reveal some common determinants of delay destruction of the kidneys. More generally, China's history draws attention to the role of unsuspected herbal remedies in the etiology of renal disease. Two cases of severe renal failure requiring dialysis, finally, have been attributed to Toulouse (France), Chinese herbs, Stephania tetrandra including dubious agents prescribed as weight loss. Another case, still unreported, as observed in London, after the use of Chinese herbs in the treatment of eczema [A. Rees, personal communication]. Interestingly, a case of Fanconi syndrome with tubular proteinuria has been reported in Japan in a patient in a complex mixture of Chinese herbs for slimming. Herbal remedies can also cause acute tubular necrosis in areas of Africa where they represent up to 35% of cases of acute renal failure. Herbs defendants include Securidaca longepeduncalata, matabalensis Euphorbia, Crotalaria laburnifolia and Callilepsis laurolea, prescribed mainly by sorcerers for impotence or sexual dysfunction, menstrual disorders, constipation.