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Banned Over Two Years Ago
[Reporter Hong Suqing / Taipei Report]
Traditional Chinese medicines containing aristolochic acid were officially banned in our country over two years ago due to cases of kidney disease reported both domestically and internationally. However, Linkou Chang Gung Hospital has recently received another case of aristolochic acid nephropathy! The hospital detected aristolochic acid in the Chinese herbal pills taken by a young boy who was admitted with combined liver and kidney failure. Pathological examination of the boy's kidneys also showed typical signs of aristolochic acid nephropathy.
The Department of Health Urges the Public Not to Purchase Unverified Chinese Medicines
In response, Chen Chongzhe, head of the Chinese Medicine Division of the Committee on Chinese Medicine and Pharmacy under the Department of Health, emphasized that legally produced Chinese medicines should not contain aristolochic acid. He urged the public to use Chinese medicines under the guidance of a physician and not to purchase unverified Chinese medicines.
Aristolochiaceae herbs have anti-inflammatory, anti-swelling, and diuretic pain-relieving effects, which is why they are often misused in weight loss products and medicines for treating soreness. In the past, there were reports of "Longdan Xiegan Tang," originally used for clearing heat and reducing fire, and nourishing the liver and blood, being misused with Aristolochiaceae herbs like Guanmutong, leading to kidney disease in long-term users.
Dr. Yu Meijing, a pediatric nephrologist at Linkou Chang Gung Children's Hospital, stated that the seven-year-old boy, who suffered from epilepsy, had brief convulsions before being admitted. Upon arrival, he was feverish, unconscious, and had reduced urine output, which later ceased entirely. Examinations revealed abnormal liver and kidney function, combined with kidney failure and fulminant hepatitis.
As the boy's epilepsy could not be cured by Western medicine, his parents, upon recommendation, gave him four to five types of Chinese medicines, including some "herbal pills" of unknown composition. Tests revealed that these pills not only contained a high concentration of aristolochic acid but also aflatoxin, likely due to improper storage of the raw materials, leading to acute kidney failure and fulminant hepatitis after more than two months of use.
Fortunately, after stopping the medication, the boy's kidney function ceased to deteriorate, and his urine output gradually returned to normal. After more than ten months of follow-up, he no longer requires additional medication for his kidneys.
However, cases received by Taichung Veterans General Hospital were not as fortunate. Dr. Fu Lingxian, director of the pediatric department, noted that a ten-year-old boy, whose parents ran a Chinese medicine shop and had been giving him long-term Chinese herbal powders for health, developed kidney failure. By the time he was transferred to the hospital, he required regular dialysis and eventually died from renal encephalopathy and cerebral hemorrhage.
Long-term Use of Aristolochic Acid Can Lead to Kidney Failure
The potential of aristolochic acid to cause kidney disease was first studied in Germany. However, it wasn't until the early 1990s, when over a hundred women in Belgium developed interstitial nephritis and severe kidney failure after long-term use of weight loss drugs containing the Chinese herb "Guangfangji," that the international community began to pay attention to aristolochic acid nephropathy.
After Belgium banned the import of Chinese medicines containing aristolochic acid in 1992, countries including the UK, Canada, Australia, and Germany followed suit in the subsequent years. The United States also banned the import of drugs containing aristolochic acid in 2001. Our country officially banned five types of Chinese medicines containing aristolochic acid in November 2003.
It is currently known that long-term exposure to low doses of aristolochic acid can lead to chronic kidney failure and specific types of renal tubular disease, while short-term high-dose use can cause acute kidney failure.
However, some experts believe that aristolochic acid nephropathy may be related to the combined use of Western medicines. For example, the Belgian incident might be linked to the combined use of vasoconstrictors by those women taking weight loss drugs.(Reporter Hong Suqing)
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Chinese Medicine Asarum Not Banned Despite Containing Aristolochic Acid
[Reporter Hong Suqing / Taipei Report]
After the ban on aristolochic acid-containing Chinese medicine, in addition to unknowingly being harmed by purchasing products of unknown origin, the misuse or incorrect use of the Chinese medicine "Asarum," which also contains aristolochic acid, can lead to kidney complications as it is not on the banned list.
Chen Chongzhe, head of the Chinese Medicine Group at the Committee on Chinese Medicine and Pharmacy of the Department of Health, stated that in 2004, Taiwan announced "Regulations on the Management of Asarum Chinese Medicinal Materials and Their Preparations." It requires that only the "root" part of Asarum, which has the lowest aristolochic acid content, be used for medicine. Since aristolochic acid is insoluble in water, it must be boiled in water during preparation.
Moreover, to prevent the dissolution of aristolochic acid due to co-solvency, all finished products must be tested to ensure they do not contain aristolochic acid before they can be sold. Therefore, consumers who purchase Chinese medicine from qualified pharmaceutical companies should not have issues with aristolochic acid.
At the end of 2003, the Department of Health announced the ban on five aristolochic acid-containing medicinal materials: Guang Fangji, Qing Mu Xiang, Guan Mu Tong, Aristolochia, and Tian Xian Teng. However, "Asarum," which also contains aristolochic acid, can still be easily purchased in Chinese medicine stores.
But Asarum can also cause aristolochic acid nephropathy! Yang Huangyu, a nephrologist at Linkou Chang Gung Hospital, recently published a case in an international journal. A 49-year-old man developed nausea and vomiting after taking the Chinese medicine "Duhuo Jisheng Tang" for four to five months for sciatica, and was found to have abnormal kidney function upon examination.
Xiao Hengyi, director of the Chinese Medicine Department at Zhenxing Hospital, pointed out that Asarum can treat soreness, cold asthma, cough, etc. In addition to being used in "Duhuo Jisheng Tang," it is also found in Xinyi San for treating allergic rhinitis and Mahuang Fuzi Xixin Tang for treating headaches. However, Asarum contains very low levels of aristolochic acid, and its professional use is safe.
Source: http:/ / www. libertytimes. com. ……6/ new/ apr/ 18/ today- life1. htm
Re-emergence of Aristolochic Acid Nephropathy
[Reporter Hong Suqing / Taipei Report]
Traditional Chinese medicines containing aristolochic acid were officially banned in our country over two years ago due to cases of kidney disease reported both domestically and internationally. However, Linkou Chang Gung Hospital has recently received another case of aristolochic acid nephropathy! The hospital detected aristolochic acid in the Chinese herbal pills taken by a young boy who was admitted with combined liver and kidney failure. Pathological examination of the boy's kidneys also showed typical signs of aristolochic acid nephropathy.
The Department of Health Urges the Public Not to Purchase Unverified Chinese Medicines
In response, Chen Chongzhe, head of the Chinese Medicine Division of the Committee on Chinese Medicine and Pharmacy under the Department of Health, emphasized that legally produced Chinese medicines should not contain aristolochic acid. He urged the public to use Chinese medicines under the guidance of a physician and not to purchase unverified Chinese medicines.
Aristolochiaceae herbs have anti-inflammatory, anti-swelling, and diuretic pain-relieving effects, which is why they are often misused in weight loss products and medicines for treating soreness. In the past, there were reports of "Longdan Xiegan Tang," originally used for clearing heat and reducing fire, and nourishing the liver and blood, being misused with Aristolochiaceae herbs like Guanmutong, leading to kidney disease in long-term users.
Dr. Yu Meijing, a pediatric nephrologist at Linkou Chang Gung Children's Hospital, stated that the seven-year-old boy, who suffered from epilepsy, had brief convulsions before being admitted. Upon arrival, he was feverish, unconscious, and had reduced urine output, which later ceased entirely. Examinations revealed abnormal liver and kidney function, combined with kidney failure and fulminant hepatitis.
As the boy's epilepsy could not be cured by Western medicine, his parents, upon recommendation, gave him four to five types of Chinese medicines, including some "herbal pills" of unknown composition. Tests revealed that these pills not only contained a high concentration of aristolochic acid but also aflatoxin, likely due to improper storage of the raw materials, leading to acute kidney failure and fulminant hepatitis after more than two months of use.
Fortunately, after stopping the medication, the boy's kidney function ceased to deteriorate, and his urine output gradually returned to normal. After more than ten months of follow-up, he no longer requires additional medication for his kidneys.
However, cases received by Taichung Veterans General Hospital were not as fortunate. Dr. Fu Lingxian, director of the pediatric department, noted that a ten-year-old boy, whose parents ran a Chinese medicine shop and had been giving him long-term Chinese herbal powders for health, developed kidney failure. By the time he was transferred to the hospital, he required regular dialysis and eventually died from renal encephalopathy and cerebral hemorrhage.
Long-term Use of Aristolochic Acid Can Lead to Kidney Failure
The potential of aristolochic acid to cause kidney disease was first studied in Germany. However, it wasn't until the early 1990s, when over a hundred women in Belgium developed interstitial nephritis and severe kidney failure after long-term use of weight loss drugs containing the Chinese herb "Guangfangji," that the international community began to pay attention to aristolochic acid nephropathy.
After Belgium banned the import of Chinese medicines containing aristolochic acid in 1992, countries including the UK, Canada, Australia, and Germany followed suit in the subsequent years. The United States also banned the import of drugs containing aristolochic acid in 2001. Our country officially banned five types of Chinese medicines containing aristolochic acid in November 2003.
It is currently known that long-term exposure to low doses of aristolochic acid can lead to chronic kidney failure and specific types of renal tubular disease, while short-term high-dose use can cause acute kidney failure.
However, some experts believe that aristolochic acid nephropathy may be related to the combined use of Western medicines. For example, the Belgian incident might be linked to the combined use of vasoconstrictors by those women taking weight loss drugs.(Reporter Hong Suqing)
-------------------------------------------------
Chinese Medicine Asarum Not Banned Despite Containing Aristolochic Acid
[Reporter Hong Suqing / Taipei Report]
After the ban on aristolochic acid-containing Chinese medicine, in addition to unknowingly being harmed by purchasing products of unknown origin, the misuse or incorrect use of the Chinese medicine "Asarum," which also contains aristolochic acid, can lead to kidney complications as it is not on the banned list.
Chen Chongzhe, head of the Chinese Medicine Group at the Committee on Chinese Medicine and Pharmacy of the Department of Health, stated that in 2004, Taiwan announced "Regulations on the Management of Asarum Chinese Medicinal Materials and Their Preparations." It requires that only the "root" part of Asarum, which has the lowest aristolochic acid content, be used for medicine. Since aristolochic acid is insoluble in water, it must be boiled in water during preparation.
Moreover, to prevent the dissolution of aristolochic acid due to co-solvency, all finished products must be tested to ensure they do not contain aristolochic acid before they can be sold. Therefore, consumers who purchase Chinese medicine from qualified pharmaceutical companies should not have issues with aristolochic acid.
At the end of 2003, the Department of Health announced the ban on five aristolochic acid-containing medicinal materials: Guang Fangji, Qing Mu Xiang, Guan Mu Tong, Aristolochia, and Tian Xian Teng. However, "Asarum," which also contains aristolochic acid, can still be easily purchased in Chinese medicine stores.
But Asarum can also cause aristolochic acid nephropathy! Yang Huangyu, a nephrologist at Linkou Chang Gung Hospital, recently published a case in an international journal. A 49-year-old man developed nausea and vomiting after taking the Chinese medicine "Duhuo Jisheng Tang" for four to five months for sciatica, and was found to have abnormal kidney function upon examination.
Xiao Hengyi, director of the Chinese Medicine Department at Zhenxing Hospital, pointed out that Asarum can treat soreness, cold asthma, cough, etc. In addition to being used in "Duhuo Jisheng Tang," it is also found in Xinyi San for treating allergic rhinitis and Mahuang Fuzi Xixin Tang for treating headaches. However, Asarum contains very low levels of aristolochic acid, and its professional use is safe.
Source: http:/ / www. libertytimes. com. ……6/ new/ apr/ 18/ today- life1. htm