alexa Hepatotoxicity from green tea: a review of the literature and two unpublished cases.
Toxicology

Toxicology

Journal of Drug Metabolism & Toxicology

Author(s): Mazzanti G, MennitiIppolito F, Moro PA, Cassetti F, Raschetti R, , Mazzanti G, MennitiIppolito F, Moro PA, Cassetti F, Raschetti R,

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Abstract PURPOSE: To review the current literature on suspected green tea-related hepatic reactions and to describe two new cases reported within the framework of the Italian surveillance system of natural health products. RESULTS: A literature search of publication between 1999 and October 2008 retrieved 34 cases of hepatitis. Histological examination of the liver revealed inflammatory reactions, cholestasis, occasional steatosis, and necrosis. A positive dechallenge was reported in 29 cases. There was one reported death. A positive rechallenge occurred in seven cases (20\%). In the two new cases, the causality assessment was judged as "possible" according to the RUCAM score. CONCLUSIONS: Our analysis of the published case reports suggests a causal association between green tea and liver damage. The hepatotoxicity is probably due to (-)-epigallocatechin gallate or its metabolites which, under particular conditions related to the patient's metabolism, can induce oxidative stress in the liver. In a few cases, toxicity related to concomitant medications could also be involved. This article was published in Eur J Clin Pharmacol and referenced in Journal of Drug Metabolism & Toxicology

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