CASE REPORTS - Tripterygium toxicity

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Zhongguo Zhong Xi Yi Jie He Za Zhi. 2009 Feb;29(2):165-8.

[Pathological study on autopsy died of tripterygium

intoxication--report of 4 cases][Article in Chinese]

Huang GZ, Li L, Liu L.

Department of Forensic Pathology, Tongji Medical College of Huazhong

University of Sciences and Technology, Wuhan.

The Tripterygium preparation, a Chinese herbal medicine, has been

widely used to treat various autoimmune diseases, such as rheumatoid

arthritis and systemic lupus erythematosus. Its significant clinical

effects have received a great praise and attention by the public

health in China, but its toxicity also definitely exists, with the

therapeutic dosage approaching the minimal toxic dosage. In order to

provide reference for the safe use of Tripterygium preparation in

clinical practice, the pathological changes of 4 autopsy cases by

Tripterygium poisoning were reported in this paper. In them, 2 cases

died of acute cardiogenic shock caused by myocardial damage, showing

hydropic degeneration of the myocardial cells, even with obvious

contraction band necrosis in the papillary muscles; the other 2 died

of severe acute renal failure due to severe acute toxic nephrosis;

cerebral edema and gastrointestinal inflammatory changes were found in

all cases. The authors suggested that careful dosage control is the

key step to prevent Tripterygium intoxication during the medical

treatments; directly using the crude Tripterygium in clinics should be

prohibited; and the Tripterygium preparation used should be produced

by the pharmaceutical companies regulated by the government.

PMID: 19382482

http://www.ncbi.nlm.nih.gov/pubmed/19382482

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