{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T19:44:41Z","timestamp":1778874281626,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,8,25]],"date-time":"2018-08-25T00:00:00Z","timestamp":1535155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Beijing Health System Talents Plan","award":["2013-3-069"],"award-info":[{"award-number":["2013-3-069"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p><jats:italic>Polygonum Multiflorum<\/jats:italic> Thumb (<jats:styled-content style=\"fixed-case\">PMT<\/jats:styled-content>), an ancient anti\u2010aging Chinese herb known traditionally as He Shou Wu, has side effects of liver toxicity. To determine the main clinical and pathological characteristics of liver toxicity induced by <jats:styled-content style=\"fixed-case\">PMT<\/jats:styled-content> and the clinical course after its cessation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data of patients, diagnosed as drug\u2010induced liver injury and hospitalised in Beijing Friendship Hospital from August 2005 to August 2017, were retrospectively reviewed. Clinical, pathological data and outcome after cessation of He Shou Wu were obtained and analysed. Kruskal\u2010Wallis and Chi\u2010square (\u03c7<jats:sup>2<\/jats:sup>) tests were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010nine patients with He Shou Wu\u2010induced liver injury were enrolled. The median age was 53\u00a0years (range 15\u201074) and 75.9% (22\/29) were women. The most common symptom was jaundice (79.3%, 23\/29). Of nine patients with liver biopsies, six showed acute cholestatic hepatitis, two acute, and one chronic hepatocellular injury pattern. The latency, liver chemistries and outcomes were comparable between pure He Shou Wu (5 patients) and its compounds (24 patients). Twenty\u2010five of 29 patients (86.2%) had normal serum alanine aminotransferase levels after 45\u00a0days (range: 10\u2010138\u00a0days) and total bilirubin of 46\u00a0days (range: 0\u2010551\u00a0days). One patient was rechallenged with He Shou Wu and two developed autoimmune features. One patient died of liver failure and three had chronic persistent liver injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The main clinicopathological injury pattern of He Shou Wu\u2010induced liver injury is moderate to severe hepatitis with or without cholestasis. Most patients recover completely; however, chronic disease and death do occur.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13939","type":"journal-article","created":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T14:21:59Z","timestamp":1533133319000},"page":"389-400","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Clinicopathological features of He Shou Wu<i>\u2010<\/i>induced liver injury: This ancient anti\u2010aging therapy is not liver\u2010friendly"],"prefix":"10.1111","volume":"39","author":[{"given":"Yan","family":"Wang","sequence":"first","affiliation":[{"name":"Liver Research Center Beijing Friendship Hospital Capital Medical University Beijing Key Laboratory on Translational Medicine on Cirrhosis National Clinical Research Center for Digestive Disease  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lan","family":"Wang","sequence":"additional","affiliation":[{"name":"Liver Research Center Beijing Friendship Hospital Capital Medical University Beijing Key Laboratory on Translational Medicine on Cirrhosis National Clinical Research Center for Digestive Disease  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romil","family":"Saxena","sequence":"additional","affiliation":[{"name":"Department of Pathology Indiana University School of Medicine  Indianapolis Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aileen","family":"Wee","sequence":"additional","affiliation":[{"name":"Department of Pathology Yong Loo Lin School of Medicine National University of Singapore National University Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruiyuan","family":"Yang","sequence":"additional","affiliation":[{"name":"Liver Research Center Beijing Friendship Hospital Capital Medical University Beijing Key Laboratory on Translational Medicine on Cirrhosis National Clinical Research Center for Digestive Disease  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiuju","family":"Tian","sequence":"additional","affiliation":[{"name":"Liver Research Center Beijing Friendship Hospital Capital Medical University Beijing Key Laboratory on Translational Medicine on Cirrhosis National Clinical Research Center for Digestive Disease  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiping","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pathology Guangzhou Kingmed Center for Clinical Laboratory  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8016-4368","authenticated-orcid":false,"given":"Xinyan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Liver Research Center Beijing Friendship Hospital Capital Medical University Beijing Key Laboratory on Translational Medicine on Cirrhosis National Clinical Research Center for Digestive Disease  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jidong","family":"Jia","sequence":"additional","affiliation":[{"name":"Liver Research Center Beijing Friendship Hospital Capital Medical University Beijing Key Laboratory on Translational Medicine on Cirrhosis National Clinical Research Center for Digestive Disease  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,8,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13323"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.138"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.01.004"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28813"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.12.051"},{"key":"e_1_2_9_7_1","article-title":"Guidelines for the diagnosis and management of herb\u2010induced liver injury","author":"Wang JB","year":"2018","journal-title":"Chin J Integr Med"},{"key":"e_1_2_9_8_1","first-page":"673","volume-title":"MacSween's pathology of the liver","author":"Kleiner DE","year":"2017"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.13082"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.path.2018.02.009"},{"key":"e_1_2_9_11_1","unstructured":"National Institutes of Health.Clinical and research information on drug\u2010induced liver injury.https:\/\/livertox.niddk.nih.gov\/. 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