PubMed · 420453
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M C Braunstein. 1979. Halothane hepatotoxicity.. https://doi.org/10.7326/0003-4819-90-1-131_2
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The appearance of toxic effects upon consumption of delayed release verapamil at therapeutic doses (120 mg/12 h) in a 64 year old patient with renal failure is described. The patient presented hypotension, bradycardia due to auriculoventricular block, hepatotoxicity, slight hyperglycemia, hyperpotassemia and metabolic acidosis with increased anionic gap. The picture remitted spontaneously with support treatment following discontinuation of the medication. The pathogenesis of the syndrome and the possibility that the hepatotoxicity was the triggering factor are discussed. Extreme precaution is recommended when this type of drugs is used in severe uremic or diabetic patients.
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OBJECTIVE: To report a multisystem illness in a patient after ingestion of Chinese herbal medicines, together with an analysis of the herbal medicine and to alert physicians to the growing clinical importance of adverse reactions to herbal remedies. CLINICAL FEATURES: A 61-year-old Chinese Vietnamese man with a history of atrial fibrillation and left cerebral hemisphere infarction three months previously presented after a three-day illness with acute hepatorenal failure, multiple pulmonary emboli, peripheral arterial thromboembolism and laboratory features of consumptive coagulopathy. For three days before presentation, he drank a daily infusion of herbal medicine. INTERVENTION: Intensive supportive medical care including haemodiafiltration resulted in recovery of renal function, liver function and return of coagulation parameters to normal over a one-month period. Toxicological analysis of an infusion prepared from a sample of the patient's herbal medicine revealed the potentially toxic compounds benzaldehyde, cinnamoyl alcohol and ephedrine. CONCLUSION: The ingestion of herbal medicine caused or contributed to the patient's illness.