WILD GERMANDER-INDUCED CHRONIC ACTIVE HEP ATITIS AND CIRRHOSIS - 3 CASES

We report 3 cases of chronic liver injury that were observed after pro longed treatment with wild germander, a herbal medicine recently prohi bited by French Ministry of Health, following several reports suggesti ng its hepatotoxicity. Chronic active hepatitis was found in 2 cases, and active cirrhosis in I case. The onset of hepatitis occurred after 6 to 7 months of treatment. Serum anti-nuclear and anti-smooth muscle antibodies were present in 2 patients. In 2 cases, wild-germander invo lvement was recognized several months after appearance of liver injury . Following treatment discontinuation, outcome was favorable in the 3 patients. These observations suggest that diagnosis of acute or chroni c liver injury of unknown origin should always include the search for herbal medicine treatment.