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Unregulated Chinese Herbal Therapy Can Be Toxic

One 30-year-old man developed bladder cancer, kidney failure after taking Longdan Xieganwan

FRIDAY, July 21 (HealthDay News) - Unregulated Chinese herbal therapy can be toxic, according to a case study of a 30-year-old man who developed bladder tumors and kidney failure after taking the Chinese herb Longdan Xieganwan for five years in an effort to enhance his liver. The report is published in the July 22 issue of The Lancet.

Longdan Xieganwan contains Caulis aristolochia manshuriensis, and aristolochic acid is an active ingredient. One study has linked cumulative doses of aristolochic acid exceeding 200 grams with bladder cancer, and the U.S. Food and Administration issued a warning about its nephrotoxicity in May 2000.

Chris Liang, M.R.C.P., of Whittington Hospital in London, and colleagues reported that the patient presented to a kidney clinic in July 2003, after passing blood in his urine. Cystoscopy revealed a bladder tumor that was successfully resected. He developed recurrent bladder cancer despite the fact that he ceased taking the herbal remedy. A subsequent renal biopsy showed interstitial fibrosis consistent with Chinese herbal nephropathy. As of June 2006, the patient was preparing for renal transplant, the researchers wrote.

In an accompanying editorial, Lancet editors wrote that complementary medications "all need regulation as drugs. And practitioners in this field need reminding, again, that they need to produce high-quality evidence of efficacy: fully powered double-blind randomized trials with relevant endpoints and sufficient follow-up, and systematic reviews."

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