The
consumption of botanicals for
therapeutic purposes has increased significantly in recent years. Drug-induced liver disease (DILI) is a frequent cause of acute
liver injury, around 50% in the
United States, and about 1% is
secondary to the use of phytotherapeuticals and
herbal supplies.
Ruellia bahiensis, a
plant species of the
Acanthaceae family, is a tropical
plant distributed in Northeastern
Brazil. In
folk medicine in the
state of Bahia, the species is known as "mãe-
boa" and is commonly used. L.S.S, a 23-year old,
female,
patient was admitted at
University Hospital of Bahia-
Brazil with
signs and symptoms of acute
hepatitis. She had made daily use of an
herbal supply popularly known as "mãe-
boa" for at least two years prescribed by a
physician. Diagnostic investigation was negative for viral and
autoimmune hepatitis,
leptospirosis,
dengue, and CMV (
cytomegalovirus). The
patient had to undergo
liver transplantation. Explant revealed
massive hepatic necrosis. According to histological findings, and after exclusion of other etiologies,
liver damage was assigned to
herbal supply. The prolonged use of
Ruellia bahiensis infusions may have caused the
liver dysfunction.