{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:05:55Z","timestamp":1786122355273,"version":"build-2736575974"},"reference-count":23,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Risk &amp; Safety in Medicine"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Medicinal plants (MPs) can cause adverse reactions (ARs) particularly affecting major detoxification organs, the kidneys. This study aims to document two cases of nephrotoxicity associated with\n                      <jats:italic toggle=\"yes\">Rubia peregrina<\/jats:italic>\n                      L. (\n                      <jats:italic toggle=\"yes\">R. peregrina)<\/jats:italic>\n                      , a plant recognized for its medicinal properties but also potential toxicity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An ethnobotanical study was conducted at Ibn Sina Hospital in Rabat, Morocco, involving two female patients aged 59 and 75, both presenting with anemia and no prior history of renal disease. Data were collected using a semi-structured questionnaire, and plant samples were identified. The study received ethical approval (n\u00b005\/23).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>Case 1: A 59-year-old woman developed chronic renal failure requiring hemodialysis after ingesting madder root powder. Causality assessment indicated a possible link to the use of the plant. Case 2: A 75-year-old woman experienced renal failure following the consumption of a madder root decoction. Causality assessment also suggested a possible association.<\/jats:p>\n                    <jats:p>Neither patient had reported ARs prior to hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This study is the first to document ARs linked to\n                      <jats:italic toggle=\"yes\">R. peregrina<\/jats:italic>\n                      in humans, highlighting the avant nephrotoxic risks associated with its anthraquinone compounds. Despite its traditional use, the potential for serious renal damage calls for caution, further research, and regulatory measures for MPs.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09246479261427137","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T05:54:02Z","timestamp":1772517242000},"page":"476-480","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adverse reactions to\n                    <i>Rubia peregrina<\/i>\n                    L.: Two case reports from Morocco"],"prefix":"10.1177","volume":"37","author":[{"given":"Khadija","family":"Dabra","sequence":"first","affiliation":[{"name":"Mohammed V University in Rabat"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souad","family":"Skalli","sequence":"additional","affiliation":[{"name":"Mohammed V University in Rabat"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12519"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.11606\/issn.1679-9836.v97i1p51-58"},{"key":"e_1_3_8_4_2","first-page":"1","article-title":"Toxicity and safety implications of herbal medicines","volume":"63","author":"Mensah ML","year":"2019","unstructured":"Mensah ML, Komlaga G, Forkuo AD, et al. Toxicity and safety implications of herbal medicines. Herbal medicine. 2019; 63: 1\u201317.","journal-title":"Herbal medicine"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/14786419.2010.511015"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/cote.12308"},{"key":"e_1_3_8_7_2","volume-title":"Flore pratique du Maroc","author":"Fennane M","year":"1999","unstructured":"Fennane M, Ibn-Tattou M. Flore pratique du Maroc: Angiospermae (Lauraceae-Neuradaceae). Inst. Scientifique, 1999, vol 1."},{"key":"e_1_3_8_8_2","unstructured":"The Uppsala Monitoring Centre. The use of the WHO-UMC system for standardised case causality assessment. https:\/\/who-umc.org\/media\/u4gjgxvv\/who-umc-causality-assessment_new-logo.pdf (6 Apr 2018 accessed 25 October 2025)"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-024-1120-1_5"},{"key":"e_1_3_8_10_2","first-page":"36","article-title":"Intoxications par les plantes et les produits de la pharmacop\u00e9e traditionnelle donn\u00e9es du centre antipoison et de pharmacovigilance du Maroc","volume":"54","author":"Rhalem N","year":"2022","unstructured":"Rhalem N. Intoxications par les plantes et les produits de la pharmacop\u00e9e traditionnelle donn\u00e9es du centre antipoison et de pharmacovigilance du Maroc. Toxicol Maroc 2022; 54: 36.","journal-title":"Toxicol Maroc"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1515\/asia-2021-0039"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.5897\/JPP2018.0507"},{"key":"e_1_3_8_13_2","first-page":"1","volume-title":"Ethnobotany of Northern Africa and Levant","author":"Elachouri M","year":"2023","unstructured":"Elachouri M, Ouasti I, Bussmann RW. Rubia peregrina L. Rubia tinctorum L. rubiaceae. In: Ethnobotany of Northern Africa and Levant. Springer, 2023, pp. 1\u201311."},{"key":"e_1_3_8_14_2","first-page":"561","article-title":"A novel naphthoquinone glycoside from Rubia peregrina L","volume":"33","author":"\u00d6zgen U","year":"2009","unstructured":"\u00d6zgen U, Kazaz C, Secen H, et al. A novel naphthoquinone glycoside from Rubia peregrina L. 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