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We report the first cases of ayurvedic herbal and homeopathic remedies-associated HAAA in two patients which proved fatal in both. Evaluation of patients with acute hepatitis and severe pancytopenia must include a detailed evaluation for complementary and alternative medicine use.<\/jats:p>","DOI":"10.1136\/bcr-2021-247867","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T11:50:47Z","timestamp":1647949847000},"page":"e247867","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Toxic hepatitis-associated aplastic anaemia after dual homeopathic remedies and Gymnema sylvestre use"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9587-336X","authenticated-orcid":false,"given":"Cyriac Abby","family":"Philips","sequence":"first","affiliation":[{"name":"Clinical and Translational Hepatology, Rajagiri Hospital, Aluva, Kerala, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arif Hussain","family":"Theruvath","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Rajagiri Hospital, Aluva, Kerala, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Resmi","family":"Ravindran","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Rajagiri Hospital, Aluva, Kerala, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"2025082709415217000_15.3.e247867.1","doi-asserted-by":"publisher","DOI":"10.1186\/1743-422X-8-87"},{"key":"2025082709415217000_15.3.e247867.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2010.08194.x"},{"key":"2025082709415217000_15.3.e247867.3","article-title":"Aplastica anemia and viral hepatitis","volume":"1","author":"Cudillo","year":"2009","journal-title":"Mediterr J Hematol Infect Dis"},{"key":"2025082709415217000_15.3.e247867.4","doi-asserted-by":"crossref","unstructured":"Alshaibani A , Dufour C , Risitano A , et al . 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