Urothelial Carcinoma Associated with the Use of a Chinese Herb (Aristolochia fangchi)

Autor: Joëlle Nortier, Daniel Abramowicz, Heinz H. Schmeiser, Volker M. Arlt, Michel Depierreux, Jean-Louis Vanherweghem, Michel Petein, Vereerstraeten P, L. De Pauw, Christian A. Bieler, M C Martinez
Rok vydání: 2000
Předmět:
Male
Pathology
Urothelium -- pathology
Kidney
Carcinogens -- adverse effects
Aristolochia
Stephania tetrandra
DNA Adducts
chemistry.chemical_compound
Autres spécialisations médicales et paramédicales
Carcinogens -- metabolism
Risk Factors
Drugs
Chinese Herbal -- adverse effects
Prevalence
Kidney Failure
Chronic -- pathology
Néphrologie - urologie
biology
Phenanthrenes -- analysis
Aristolochia clematitis
General Medicine
Middle Aged
Ochratoxins
Ureter -- pathology
Phenanthrenes -- metabolism
Kidney Failure
Chronic -- chemically induced
Aristolochic Acids
Female
Urologic Neoplasms
medicine.medical_specialty
Urinary system
Phenanthrenes -- adverse effects
Urologic Neoplasms -- chemically induced
Aristolochic acid
Urology
complex mixtures
Nephropathy
Homéopathie
DNA Adducts -- analysis
Urologic Neoplasms -- pathology
medicine
Humans
Carcinogens -- analysis
Ochratoxins -- analysis
Dose-Response Relationship
Drug
business.industry
Phenanthrenes
biology.organism_classification
medicine.disease
Kidney Failure
Chronic -- therapy
Anti-Obesity Agents -- adverse effects
Cancérologie
Transplantation
chemistry
Carcinogens
Kidney Failure
Chronic
Anti-Obesity Agents
Ureter
Urothelium
Kidney -- pathology
business
Drugs
Chinese Herbal
Balkan Nephropathy
Zdroj: The New England journal of medicine, 342 (23
ISSN: 1533-4406
0028-4793
Popis: BACKGROUND: Chinese-herb nephropathy is a progressive form of renal fibrosis that develops in some patients who take weight-reducing pills containing Chinese herbs. Because of a manufacturing error, one of the herbs in these pills (Stephania tetrandra) was inadvertently replaced by Aristolochia fangchi, which is nephrotoxic and carcinogenic. METHODS: The diagnosis of a neoplastic lesion in the native urinary tract of a renal-transplant recipient who had Chinese-herb nephropathy prompted us to propose regular cystoscopic examinations and the prophylactic removal of the native kidneys and ureters in all our patients with end-stage Chinese-herb nephropathy who were being treated with either transplantation or dialysis. Surgical specimens were examined histologically and analyzed for the presence of DNA adducts formed by aristolochic acid. All prescriptions written for Chinese-herb weight-reducing compounds during the period of exposure (1990 to 1992) in these patients were obtained, and the cumulative doses were calculated. RESULTS: Among 39 patients who agreed to undergo prophylactic surgery, there were 18 cases of urothelial carcinoma (prevalence, 46 percent; 95 percent confidence interval, 29 to 62 percent): 17 cases of carcinoma of the ureter, renal pelvis, or both and 1 papillary bladder tumor. Nineteen of the remaining patients had mild-to-moderate urothelial dysplasia, and two had normal urothelium. All tissue samples analyzed contained aristolochic acid-related DNA adducts. The cumulative dose of aristolochia was a significant risk factor for urothelial carcinoma, with total doses of more than 200 g associated with a higher risk of urothelial carcinoma. CONCLUSIONS: The prevalence of urothelial carcinoma among patients with end-stage Chinese-herb nephropathy (caused by aristolochia species) is a high.
Journal Article
Research Support, Non-U.S. Gov't
info:eu-repo/semantics/published
Databáze: OpenAIRE
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