{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:16:22Z","timestamp":1786968982197,"version":"build-2736575974"},"reference-count":25,"publisher":"BMJ","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[2002,9]]},"abstract":"<jats:p>\n                  <jats:bold>Background\/Aims:<\/jats:bold> A child presented with hepatic veno-occlusive disease after having been administered a short course of treatment with a traditional herbal remedy. The child subsequently died. Postmortem liver histology confirmed the diagnosis. This study aimed to investigate the hypothesis that the herbal remedy was the cause of veno-occlusive disease.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Methods:<\/jats:bold> Extracts of the traditional remedy were analysed by colorimetry and gas chromatography\/mass spectrometry. Cultured hepatocytes were treated with an extract of the plant material and examined for morphological changes.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Results:<\/jats:bold> The screening analyses indicated the presence of toxic pyrrolizidine alkaloids, which were later confirmed by gas chromatography\/mass spectrometry. The cell studies indicated dose related toxicity, with necrosis at high concentrations and apoptosis and abnormalities of the cytoskeleton at lower concentrations.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusions:<\/jats:bold> The simple screening techniques used allowed rapid confirmation of the presence of toxic pyrrolizidines in the remedy. The in vitro method confirmed the toxicity of herbal extracts to hepatocytes.<\/jats:p>","DOI":"10.1136\/jcp.55.9.676","type":"journal-article","created":{"date-parts":[[2002,8,26]],"date-time":"2002-08-26T11:49:59Z","timestamp":1030362599000},"page":"676-679","source":"Crossref","is-referenced-by-count":43,"title":["Hepatic veno-occlusive disease as a result of a traditional remedy: confirmation of toxic pyrrolizidine alkaloids as the cause, using an in vitro technique"],"prefix":"10.1136","volume":"55","author":[{"given":"M","family":"Zuckerman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Steenkamp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M J","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2002,9,1]]},"reference":[{"key":"2025092502064630000_55.9.676.1","first-page":"62","volume":"75","year":"1989","journal-title":"S Afr Med J"},{"key":"2025092502064630000_55.9.676.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)00020-4"},{"key":"2025092502064630000_55.9.676.3","first-page":"885","volume":"27","year":"1951","journal-title":"Am J Pathol"},{"key":"2025092502064630000_55.9.676.4","first-page":"126","volume":"42","year":"1968","journal-title":"S Afr Med J"},{"key":"2025092502064630000_55.9.676.5","first-page":"99","volume":"65","year":"1997","journal-title":"Tijdschr Kindergeneeskd"},{"key":"2025092502064630000_55.9.676.6","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1016\/S0016-5085(85)80027-5","volume":"88","year":"1985","journal-title":"Gastroenterology"},{"key":"2025092502064630000_55.9.676.7","first-page":"43","volume":"112","year":"1988","journal-title":"J Paediatr"},{"key":"2025092502064630000_55.9.676.8","doi-asserted-by":"publisher","DOI":"10.1007\/BF01991912"},{"key":"2025092502064630000_55.9.676.9","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/0305-1978(92)90103-K","volume":"20","year":"1992","journal-title":"Biochem Syst Ecol"},{"key":"2025092502064630000_55.9.676.10","doi-asserted-by":"publisher","DOI":"10.1016\/0031-9422(81)85124-2"},{"key":"2025092502064630000_55.9.676.11","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1021\/ac60248a006","volume":"39","year":"1967","journal-title":"Anal Chem"},{"key":"2025092502064630000_55.9.676.12","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1021\/jf00051a025","volume":"43","year":"1995","journal-title":"J Agric Food Chem"},{"key":"2025092502064630000_55.9.676.13","doi-asserted-by":"publisher","DOI":"10.1016\/0022-4731(89)90455-X"},{"key":"2025092502064630000_55.9.676.14","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1039\/CT9099500466","volume":"95","year":"1909","journal-title":"Journal of the Chemical Society of the Transvaal"},{"key":"2025092502064630000_55.9.676.15","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/S0002-9343(89)80492-9","volume":"87","year":"1989","journal-title":"Am J Med"},{"key":"2025092502064630000_55.9.676.16","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1136\/bmj.295.6591.183","volume":"295","year":"1987","journal-title":"BMJ"},{"key":"2025092502064630000_55.9.676.17","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.29.9.788"},{"key":"2025092502064630000_55.9.676.18","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1007\/BF01991912","volume":"154","year":"1995","journal-title":"Eur J Pediatr"},{"key":"2025092502064630000_55.9.676.19","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-200006000-00011"},{"key":"2025092502064630000_55.9.676.20","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1038\/bjc.1960.70","volume":"14","year":"1960","journal-title":"Br J Cancer"},{"key":"2025092502064630000_55.9.676.21","first-page":"361","volume":"50","year":"1969","journal-title":"Br J Exp Pathol"},{"key":"2025092502064630000_55.9.676.22","first-page":"138","volume":"53","year":"1971","journal-title":"Br J Exp Pathol"},{"key":"2025092502064630000_55.9.676.23","unstructured":"Steenkamp V, Stewart M, van der Merwe S, et al. 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