Hepatotoxicity induced by paclitaxel interaction with turmeric in association with a microcystin from a contaminated dietary supplement
Copyright policy )Hepatotoxicity induced by paclitaxel interaction with turmeric in association with a microcystin from a contaminated dietary supplement
A 67-year-old Caucasian male with lung cancer was presented to the Emergency Department with asthenia, anorexia, jaundice and choluria. The patient's lung cancer was being treated medically by a combination of paclitaxel/carboplatin with bi-monthly frequency. The patient was also self-medicating with several natural products, including Chlorella (520 mg/day), Silybum marianum (total of 13.5 mg silymarin/day), zinc sulphate (5.5 mg), selenium (50 μg) and 15 g/day of Curcuma longa. In first chemotherapy cycle no toxicity was observed even he was taking other medications as budesonide and sitagliptin. The toxic events started only after the introduction of the dietary products. Chlorella had contamination with cyanobacteria (Oscillatoriales) and 1.08 μg of cyanotoxin Microcystin-LR (MC-LR) per gram of biomass was found. Patient was consuming ca 0.01 μg MC-LR/kg/day. This case report describes the first known case of paclitaxel toxicity probably related to pharmacokinetic interaction with Turmeric and a contaminated Chlorella supplement resulting in an acute toxic hepatitis and the impact on oncologic patient health.
- Centro Interdisciplinar de Investigação Marinha e Ambiental Portugal
- Northwestern State University United States
- University of Coimbra Portugal
- University of Porto Portugal
- Universidade do Porto Portugal
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Male, natural product, Chlorella, jaundice, paclitaxel, aspartate aminotransferase, lung emphysema, selenium, drug contamination, bilirubin blood level, clinical article, non insulin dependent diabetes mellitus, turmeric, drug effect, atorvastatin, toxic hepatitis, liver toxicity, Chlorella extract, aged, priority journal, Liver, anorexia, food contamination, drug withdrawal, laboratory test, carboplatin, self medication, bilirubin, Chemical and Drug Induced Liver Injury, Drug Contamination, budesonide, microcystin, Silybum marianum extract, Microcystins, Paclitaxel, alanine aminotransferase, enzymology, herb drug interaction, Herb-Drug Interactions, formoterol, chemistry, liver, Cyanobacteria, Curcuma longa extract, alfuzosin, sitagliptin, Article, cancer chemotherapy, multiple cycle treatment, Curcuma, male, cyanobacterium, tiotropium bromide, case report, Humans, human, prostate hypertrophy, Aged, choluria, metformin plus sitagliptin, patient attitude, biomass, isolation and purification, disease association, dyslipidemia, hypertransaminasemia, zinc sulfate, pruritus, lung adenocarcinoma, microcystin LR, antihistaminic agent, dietary supplement, Dietary Supplements, asthenia, metformin, aspartate aminotransferase blood level, alanine aminotransferase blood level, erythema
