Multiple tubular dysfunction induced by mixed Chinese herbal medicines containing cadmium

Abstract

Traditional Chinese herbal medicine remains very popular in Taiwan. Here, Western medicine is readily available at affordable price, yet many local population choose Chinese herbal medicine as an alternative or complementary source of health-care even at a higher cost. The preference of Chinese herbal medicine comes from the generalized belief that herbs are natural, more gentle, and less toxic than synthetic Western medicine. Incidents of herbal poisoning are rare, mild, and obviously underestimated in literature [1]. Recently, Professor Vanherweghem and colleagues [2] reported rapidly progressive interstitial renal fibrosis in nine young women who had followed a slimming regimen including Chinese herbs. The report raised concern about nephrotoxicity of a cocktail of Chinese herbs. Several components were suspected to respond to the interstitial fibrosis, although no one was certain [3]. In addition, any herbal products can be contaminated during production and processing, especially by heavy metals or mycotoxin [3]. We report on a young woman who took a cocktail of Chinese herbs contaminated by cadmium and developed a unique syndrome of multiple renal tubular dysfunction not fully explained by cadmium-induced tubulopathy [4].