Hepatotoxicity of Teucrium chamaedrys L. decoction: role of difference in the harvesting area and preparation method.

AIM: Two recurrent cases of severe acute liver injury attributed to the use of a wild germander decoction, prepared with some variation in traditional method has been reported. The aim of the present study was to correlate the hepatotoxic effect observed in patients who consumed germander decoction with teucrin A levels. Antioxidant properties were analyzed to assess any possible differences between the decoction used traditionally by the family (without negative consequences) and the decoction taken by the patients. MATERIALS AND METHODS: Different types of germander decoctions were prepared in the laboratory by simulating the same conditions for preparing the decoction by the patients and their family members. The levels of teucrin A, the polyphenols and the antioxidant power were determined. One-way analysis of variance was used to test for differences between the groups. RESULTS AND CONCLUSIONS: The extract consumed by the patients had higher concentration of teucrin A, lower antioxidant activity and lower content of polyphenols compared with the traditional decoction, revealing an inverse relationship between teucrin A content and antioxidant capacity. These case reports emphasize that more information is needed on the safety and quality of these natural products.

Two contemporary cases of hepatitis associated with Teucrium chamaedrys L. decoction use: case reports and review of literature.

Teucrium chamaedrys L. is a herbaceous plant common in European woods that has been used for many purposes for centuries. Recently, T. chamaedrys L. has become popular as a slimming decoction without any scientific proof of efficacy notwithstanding its well-known hepatotoxicity. Hydroalcoholic extracts are currently used as flavourings in the preparation of wines, bitters and liqueurs. Teucrin A and teuchamaedryn A are the major toxic components of the diterpenoid fraction of T. chamaedrys L.

Case studies to explore the pitfalls in the diagnosis of sarcoidosis.

Sarcoidosis is a multisystemic disorder of unknown cause. Diagnosis is established when clinical and radiological findings are supported by histological evidence of noncaseating epitheloid cell granulomas. Exclusion of granulomas of known causes and sarcoidlike reactions is mandatory. A lot of infections may mimic a sarcoidlike granulomatous reaction. Even with well advanced pathological and microbiological examination, it could be hard to make the appropriate diagnosis. Moreover, sarcoidosis patients receiving corticosteroids are susceptible to opportunistic infections. The challenge is, however, making the right diagnosis because opportunistic infections can resemble sarcoidosis. The case reports presented in this paper are meant to stress the importance of excluding granulomatous infections in patients with (suspected) sarcoidosis. Appropriate diagnostic procedures are important to exclude an infectious condition mimicking sarcoidosis. Accordingly, appropriate treatment can start without further delay.