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https://hdl.handle.net/10216/120309| Author(s): | Costa M.L. Rodrigues J.A. Azevedo J. Vasconcelos V. Eiras E. Campos M.G. |
| Title: | Hepatotoxicity induced by paclitaxel interaction with turmeric in association with a microcystin from a contaminated dietary supplement |
| Publisher: | Elsevier |
| Issue Date: | 2018 |
| Abstract: | 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. © 2018 Elsevier |
| Subject: | alanine aminotransferase alfuzosin antihistaminic agent aspartate aminotransferase atorvastatin bilirubin budesonide carboplatin Chlorella extract Curcuma longa extract formoterol metformin metformin plus sitagliptin microcystin microcystin LR natural product paclitaxel selenium Silybum marianum extract sitagliptin tiotropium bromide turmeric zinc sulfate microcystin paclitaxel aged alanine aminotransferase blood level anorexia Article aspartate aminotransferase blood level asthenia bilirubin blood level biomass cancer chemotherapy case report choluria clinical article cyanobacterium dietary supplement disease association drug withdrawal dyslipidemia erythema food contamination human hypertransaminasemia jaundice laboratory test liver toxicity lung adenocarcinoma lung emphysema male multiple cycle treatment non insulin dependent diabetes mellitus patient attitude priority journal prostate hypertrophy pruritus self medication chemistry Chlorella Curcuma dietary supplement drug contamination drug effect enzymology herb drug interaction isolation and purification liver toxic hepatitis Aged Chemical and Drug Induced Liver Injury Chlorella Curcuma Cyanobacteria Dietary Supplements Drug Contamination Herb-Drug Interactions Humans Liver Male Microcystins Paclitaxel |
| DOI: | 10.1016/j.toxicon.2018.05.022 |
| URI: | https://hdl.handle.net/10216/120309 |
| Source: | Toxicon, vol. 150, p. 207-211 |
| Related Information: | info:eu-repo/grantAgreement/FCT/5876/147268/PT |
| Document Type: | Artigo em Revista Científica Internacional |
| Rights: | restrictedAccess |
| Appears in Collections: | CIIMAR - Artigo em Revista Científica Internacional |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| Costa ML_2018.pdf Restricted Access | 1.06 MB | Adobe PDF | View/Open |
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