{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:14:12Z","timestamp":1789100052581,"version":"build-2803163510"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T00:00:00Z","timestamp":1712188800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T00:00:00Z","timestamp":1712188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Complement Med Ther"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Catharanthus roseus, a Madagascar native flowering plant, is known for its glossy leaves and vibrant flowers, and its medicinal significance due to its alkaloid compounds. As a source of vinblastine and vincristine used in chemotherapy, Catharanthus roseus is also employed in traditional medicine with its flower and stalks in dried form. Its toxicity can lead to various adverse effects. We report a case of Catharanthus roseus juice toxicity presenting as acute cholangitis, emphasizing the importance of healthcare providers obtaining detailed herbal supplement histories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 65-year-old woman presented with abdominal pain, fever, anorexia, and lower limb numbness. Initial diagnosis of acute cholangitis was considered, but imaging excluded common bile duct stones. Further investigation revealed a history of ingesting Catharanthus roseus juice for neck pain. Laboratory findings showed leukocytosis, elevated liver enzymes, and hyperbilirubinemia. The patient developed gastric ulcers, possibly due to alkaloids in Catharanthus roseus. No bacterial growth was noted in blood cultures. The patient recovered after discontinuing the herbal extract.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Catharanthus roseus toxicity can manifest as fever, hepatotoxicity with cholestatic jaundice, and gastric ulcers, mimicking acute cholangitis. Awareness of herbal supplement use and potential toxicities is crucial for healthcare providers to ensure prompt diagnosis and appropriate management. This case emphasizes the need for public awareness regarding the possible toxicity of therapeutic herbs and the importance of comprehensive patient histories in healthcare settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12906-024-04441-1","type":"journal-article","created":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T00:07:47Z","timestamp":1712189267000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Catharanthus roseus intoxication mimicking acute cholangitis"],"prefix":"10.1186","volume":"24","author":[{"given":"Yoen Young","family":"Chuah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeong Yeh","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chu-Kuang","family":"Chou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Jen","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,4]]},"reference":[{"key":"4441_CR1","first-page":"27","volume":"69","author":"VT DeVita","year":"1969","unstructured":"DeVita VT, Chu E. Vinca alkaloids in the treatment of Hodgkin\u2019s disease and other lymphomas. Ann Intern Med. 1969;69:27\u201343.","journal-title":"Ann Intern Med"},{"issue":"10","key":"4441_CR2","doi-asserted-by":"publisher","first-page":"1449","DOI":"10.1002\/ptr.4609","volume":"26","author":"S Man","year":"2012","unstructured":"Man S, Gao W, Wei C, Liu C. Anticancer drugs from traditional toxic Chinese medicines. Phytother Res. 2012;26(10):1449\u201365. https:\/\/doi.org\/10.1002\/ptr.4609.","journal-title":"Phytother Res"},{"issue":"8","key":"4441_CR3","doi-asserted-by":"publisher","first-page":"2004","DOI":"10.1111\/trf.12574","volume":"54","author":"L Cooling","year":"2014","unstructured":"Cooling L, Bombery M, Hoffmann S, Davenport R, Robertson P, Levine JE. The impact of recent vincristine on human hematopoietic progenitor cell collection in pediatric patients with central nervous system tumors. Transfusion. 2014;54(8):2004\u201314.","journal-title":"Transfusion"},{"key":"4441_CR4","doi-asserted-by":"publisher","first-page":"174","DOI":"10.3389\/fnmol.2017.00174","volume":"10","author":"H Starobova","year":"2017","unstructured":"Starobova H, Vetter I. Pathophysiology of Chemotherapy-Induced Peripheral Neuropathy. Front Mol Neurosci. 2017;10:174.","journal-title":"Front Mol Neurosci"},{"issue":"3","key":"4441_CR5","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1007\/s00280-019-03884-5","volume":"84","author":"ML Madsen","year":"2019","unstructured":"Madsen ML, Due H, Ejskj\u00e6r N, Jensen P, Madsen J, Dybk\u00e6r K. Aspects of vincristine-induced neuropathy in hematologic malignancies: a systematic review. Cancer Chemother Pharmacol. 2019;84(3):471\u201385.","journal-title":"Cancer Chemother Pharmacol"},{"issue":"3","key":"4441_CR6","first-page":"Ff01","volume":"11","author":"VR Vutukuri","year":"2017","unstructured":"Vutukuri VR, Das MC, Reddy M, Prabodh S, Sunethri P. Evaluation of Acute oral toxicity of ethanol leaves Extract of Catharanthus roseus in Wistar albino rats. J Clin Diagn Res. 2017;11(3):Ff01\u20134.","journal-title":"J Clin Diagn Res"},{"issue":"2","key":"4441_CR7","first-page":"95","volume":"2","author":"A Grigorian","year":"2014","unstructured":"Grigorian A, O\u2019Brien CB. Hepatotoxicity secondary to Chemotherapy. J Clin Transl Hepatol. 2014;2(2):95\u2013102.","journal-title":"J Clin Transl Hepatol"},{"issue":"4","key":"4441_CR8","first-page":"66","volume":"70","author":"A Aydogan","year":"2015","unstructured":"Aydogan A, Sezer K, Ozman O, Haligur M, Albay M. Catharanthus roseus toxicity in Sheep: clinical and pathological investigations of Accidental Catharanthus roseus toxicity in Sheep. Isr J Vet Med. 2015;70(4):66\u201371.","journal-title":"Isr J Vet Med"},{"issue":"11","key":"4441_CR9","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1002\/ptr.5185","volume":"28","author":"G Kaur","year":"2014","unstructured":"Kaur G, Athar M. Tannins: their beneficial role in health and disease. Phytother Res. 2014;28(11):1581\u201393.","journal-title":"Phytother Res"},{"issue":"3","key":"4441_CR10","first-page":"49","volume":"2","author":"R Awad","year":"2002","unstructured":"Awad R, Arnason JT. Tannins: isolation from Hamamelis virginiana and pharmacological properties. J Herb Pharmacother. 2002;2(3):49\u201380.","journal-title":"J Herb Pharmacother"},{"issue":"12","key":"4441_CR11","doi-asserted-by":"publisher","first-page":"3875","DOI":"10.1016\/0031-9422(91)83426-L","volume":"30","author":"A Scalbert","year":"1991","unstructured":"Scalbert A. Antimicrobial properties of tannins. Phytochemistry. 1991;30(12):3875\u201383.","journal-title":"Phytochemistry"}],"container-title":["BMC Complementary Medicine and Therapies"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12906-024-04441-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12906-024-04441-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12906-024-04441-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T00:07:56Z","timestamp":1712189276000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccomplementalternmed.biomedcentral.com\/articles\/10.1186\/s12906-024-04441-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,4]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4441"],"URL":"https:\/\/doi.org\/10.1186\/s12906-024-04441-1","relation":{},"ISSN":["2662-7671"],"issn-type":[{"value":"2662-7671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,4]]},"assertion":[{"value":"26 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Institutional Review Board approval was not required for this case report, because according to the national guidelines, the article is exempt from ethi cal committee approval as it is a case report of a patient previously seen.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Consent to publish is required from patient to publish this report. Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The author declares no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"139"}}