Acute hepatitis induced by greater celandine (chelidonium majus)

Herbal drugs have become increasingly fashionable, are commonly used as over-the-counter remedies and are generally believed to be harmless. Nevertheless there is an accumulating body of evidence that these drugs fre- quently cause toxicity, as shown in the following case. A 58-year-old woman was seen on consultation because of painless jaundice with dark urine and pale stools. She had a history of blood transfusions when delivering. Moreover she had a gastric banding for obe- sity in 2004 after which she lost 20 kg of weight. The last few months her weight was stable. The jaundice started one week before consultation. There were no other complaints, there was no pruritus. She didn't drink alcohol and had smoked 5 cigarettes a day in previous years. There was no medication use beside tablets of medicinal herbs for muscular pain since 6 weeks and - started after the jaundice - supplements of vitamins. She was retired and frequently took care of her grandchildren.