Korean J Med.  2006 Aug;71(2):224-228.

A case of chinese herb nephropathy induced by aristolochia fangchi

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea. jshan@snu.ac.kr
  • 2Department of Internal Medicine, Bundang Jesaeng General Hospital, Sungnam, Korea.

Abstract

Chinese herb nephropathy (CHN) is characterized by progressive tubulointerstitial nephritis and development of renal failure in a couple of years after diagnosis. Aristolochic acid (AA) is believed to be associated with the development of CHN. The authors report a case of CHN in which AA in the herb regimen was identified by high-performance liquid chromatography (HPLC). A 32-year-old female presented with nausea, vomiting and generalized weakness. She had been taking Chinese herbs for symptomatic care. Clinical and laboratory examinations revealed Fanconi syndrome, renal failure, and severe anemia. Renal biopsy showed severe tubulointerstitial nephritis with moderate tubular atrophy and interstitial fibrosis. She developed end-stage renal failure 4 months after diagnosis. The herb she had been taking was Aristolochia fangchi. HPLC technique was used to identify AA and to measure its concentration in the herb. From the clinical and laboratory data, the patient was diagnosed with CHN caused by aristolochic acid.

Keyword

Aristolochic acids; Aristolochia; Tubulointerstitial nephritis

MeSH Terms

Adult
Anemia
Aristolochia*
Aristolochic Acids
Asian Continental Ancestry Group*
Atrophy
Biopsy
Chromatography, High Pressure Liquid
Chromatography, Liquid
Diagnosis
Fanconi Syndrome
Female
Fibrosis
Humans
Kidney Failure, Chronic
Nausea
Nephritis, Interstitial
Renal Insufficiency
Vomiting
Aristolochic Acids
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