CHM as a trigger for autoimmune hemolytic anemia?

[Guest guest]

Hi All,

 

One case of autoimmune hemolytic anemia was associated with a

TCM formula [Wei'ande]. See abstract below.

 

From the herbs listed in the formula (below), which one(s) can cause

haemolysis?

 

http://tinyurl.com/yhn9blq + http://tinyurl.com/yzadrof say:

Weide'an Pian / Weide'an Jiaonang ST-

Calming Tabs / Med Caps: Baizhu, Banxia (Jiang), Binglang,

Cangzhu, Caodoukou, Chenpi (Zhi ), Chuanxiong, Fuling, Gancao,

Ganjiang, Gualou, Haipiaoxiao, Houpo, Huangbai, Huangqin, Laifuzi,

Maiya, Malancao , MUXIANG, Shanjiangzi

(Alpinia), Shenqu, Xiangfu (Zhi ), Zexie, Zhishi (Luyi) (

), Ziheche;

Dose: 5 X 475mg Tabs TID-QID (total 7.1-9.5g Extract / d) / 2-3 X

550mg Caps TID-QID (total 3.3-6.6g Extract / d); take fasting w

warm water;

 

Actions: Tone SP; Digestive; Aid ST Fx; Harmonise ST + Anodyne

; Move Food Stag;

 

Uses: ST pain ; ST hyperacidity ; gastritis~ chronic,

ST ulcer, duodenum ulcer;

 

CI in Xu children & elderly cases; CAUTION / CI in pregnancy;

AVOID in ST pain~ severe, emesis, melaena; AVOID spicy food; use

w medical approval in ST pain~ acute / in ST ulcer~ active; consult

hospital if not improved in 3d

 

Borneol / Camphor / Napthalenes were not mentioned in the formula.

I cannot see any obvious candidate there to cause haemolysis. Can

you?

 

 

Borneol / Camphor / napthalenes can cause haemolysis. See:

http://tinyurl.com/yf4buvg.

 

Do you use Borneol or Camphor in your formulas for oral use? Any

problemst?

 

Shen Y (2009) Autoimmune hemolytic anemia associated w a

formulation of traditional Chinese medicines. Am J Health Syst

Pharm. 2009 Oct 1;66(19):1701-3. Dept of Hematology, Second

Hospital of Shantou University Medical College, No. 22 Xinling

Road, Shantou City 515041, China. shenyoujin

PURPOSE: A case of autoimmune hemolytic anemia (AIHA) after

treatment w a CHM preparation is reported. SUMMARY: A 29-year-

old woman was admitted to the hospital w the primary complaints of

icterus, tea-colored urine, & fatigue lasting 10 days. 13 days prior, she

went to a local private clinic seeking treatment for mild stomach pain

& general malaise & was given Weide'an Pian. She took 4 tablets of

Weide'an, a Chinese herbal preparation, orally TID for 2 days. After 2

days, she experienced fatigue, dizziness, & chest distress &

subsequently discontinued treatment. On examination, she exhibited

mild scleral & mucosal icterus. Her conjunctivas were pale, & her

skin was slightly icterusd. Preliminary laboratory tests found a low

hemoglobin level & an elevated reticulocyte count. Biochemical tests

showed an elevated total serum bilirubin concentration w indirect

hyperbilirubinemia. Coombs' test results were positive for IgG but

negative for C3. All other test results were normal. She was

diagnosed w AIHA secondary to Weide'an use, & she was treated

promptly w oral prednisone, i.v. cimetidine, & oral sodium

bicarbonate tablets. 7 days later, she showed clinical improvement.

Her hemoglobin level rapidly increased to above 100 g/L, w a

corresponding decrease in her reticulocyte count & serum bilirubin

value over the next 8 days. She was discharged 15 days after

admission & was asymptomatic at a three-week follow-up visit.

CONCLUSION: Weide'an FORMULA was associated w AIHA in a

woman taking the remedy for gastritis. PMID: 19767374 [PubMed -

indexed for MEDLINE]

 

Best regards,