Cascara sagrada-induced intrahepatic cholestasis causing portal
hypertension: case report and review of herbal hepatotoxicity.
Nadir A, Reddy D, Van Thiel DH
Division of Gastroenterology, Texas Tech University Health Science Center, USA.
[Medline record in process]
Herbal medicines are gaining widespread popularity. Much of the public believes that
botanical herbs are both harmless and useful for the treatment of a variety of symptoms.
This belief stands in contrast with the fact that many herbal therapies have been shown to
be toxic. In the present case report, cascara sagrada (CS) has been associated with the
development of cholestatic hepatitis, complicated by portal hypertension. CS is a mixture
of ingredients, among which is anthracene glycoside--an herbal agent that previously has
been associated with chronic hepatitis. The liver injury in the case herein reported is
believed to be related to either anthracene glycoside or one of the other constituents of
CS.