Syndrome of inappropriate antidiuretic hormone secretion induced by the
            phytotherapy Harpagophytum procumbers: case report

Carvalho, Renata Reis de; Donadel, Camila Dermínio; Cortez, Arthur Fernandes; Valviesse, Vitor Ribeiro Gomes de Almeida; Vianna, Pedro Felipe De Almeida; Corrêa, Bruno Bordallo

doi:10.5935/0101-2800.20170013

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…A variety of Devil's Claw products and dietary supplements have been commercially marketed for over 50 years and are widely used for inflammatory health conditions such as arthritis, lower back pain, rheumatism and neuralgia [20]. While clinical studies conducted over the past twenty years support the general safety of such products, infrequent gastrointestinal disturbances (diarrhea, nausea, vomiting, abdominal pain), headache and vertigo, electrolyte imbalance, hypertension, and hypersensitivity (allergic) reactions (rash, hives and face swelling) have been documented [4,[21][22][23][24][25]. Most toxicologic studies of Devil's Claw materials have used products that were not chemically defined [26][27][28] and used only male rats.…”

Section: Discussionmentioning

confidence: 99%

Toxicology studies of aqueous-alcohol extracts of Harpagophytum procumbens subsp. procumbens (Burch.) DC.Ex Meisn. (Pedaliaceae) in female and male rats

Joshi

Parrish

Grunz-Borgmann

et al. 2020

BMC Complement Med Ther

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Background: A variety of medicinal products prepared from secondary tubers of Harpagophytum procumbens subsp. procumbens (Burch.) DC.ex Meisn. (Devil's Claw) and H. zeyheri are marketed in Africa, Europe, the United States, South America and elsewhere, where they are used for inflammatory and musculoskeletal conditions such as arthritis, lower back pain, rheumatism and neuralgia, etc. While clinical studies conducted over the last twenty years support the general safety of such products, infrequent gastrointestinal disturbances (diarrhea, nausea, vomiting, abdominal pain), headache, vertigo and hypersensitivity (allergic) reactions (rash, hives and face swelling) have been documented. Sex-related differences occur in the health conditions for which Devil's Claw products are used, so it is likely that usage is similarly sex-related and so might be side effects and potential toxicities. However toxicologic studies of Devil's Claw products have been conducted primarily with male animals. To address this deficit, we report toxicological studies in female and male rats of several H. procumbens (HP) aqueous-alcohol extracts chemically analyzed by UPLC-MS. Methods: Female and male Sprague Dawley rats were studied for one and three months in groups differing by consumption of diets without and with HP extracts at a 7-10-fold human equivalent dose (HED). Sera were analyzed for blood chemistry, and heart, liver, lung, kidney, stomach, and small and large intestine tissues were examined for histopathology. Treatment group differences for blood chemistry were analyzed by ANOVA with Dunnett's test and significant group differences for endpoints with marginal distributional properties were verified using the Kruskal-Wallis test. Group differences for histopathology were tested using Chi Square analysis. Results: Significant group by sex-related differences in blood chemistry were detected in both studies. Additionally, several sex-related differences occurred between the studies. However, significant histopathology effects associated with the consumption of the extracts were not detected. Conclusion: Toxicologic analysis of Devil's Claw extracts cause significant sex-related effects in blood chemistry. However, in our judgement, none of the observed effects suggest serious toxicity at these doses and durations. Subsequent toxicologic and clinical studies of H. procumbens and other medicines with similar properties should explore in greater detail the basis and consequences of potential sex-related effects.

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Section: Discussionmentioning

confidence: 99%

Toxicology studies of aqueous-alcohol extracts of Harpagophytum procumbens subsp. procumbens (Burch.) DC.Ex Meisn. (Pedaliaceae) in female and male rats

Joshi

Parrish

Grunz-Borgmann

et al. 2020

BMC Complement Med Ther

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“…A case of hyponatremia in a patient with systemic hypertension has been associated with Harpagophytum (co-medications were losartan, clonidine, omeprazole, and simvastatin) [ 569 ]. Another case report suggests development of grade 2 symptomatic hypertension in a normotensive woman during self-administration of Harpagophytum [ 570 ].…”

Section: Clinical Researchmentioning

confidence: 99%

From Bush Medicine to Modern Phytopharmaceutical: A Bibliographic Review of Devil’s Claw (Harpagophytum spp.)

Brendler

2021

Pharmaceuticals

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Devil’s claw (Harpagophytum spp., Pedaliaceae) is one of the best-documented phytomedicines. Its mode of action is largely elucidated, and its efficacy and excellent safety profile have been demonstrated in a long list of clinical investigations. The author conducted a bibliographic review which not only included peer-reviewed papers published in scientific journals but also a vast amount of grey literature, such as theses and reports initiated by governmental as well as non-governmental organizations, thus allowing for a more holistic presentation of the available evidence. Close to 700 sources published over the course of two centuries were identified, confirmed, and cataloged. The purpose of the review is three-fold: to trace the historical milestones in devil’s claw becoming a modern herbal medicine, to point out gaps in the seemingly all-encompassing body of research, and to provide the reader with a reliable and comprehensive bibliography. The review covers aspects of ethnobotany, taxonomy, history of product development and commercialization, chemistry, pharmacology, toxicology, as well as clinical efficacy and safety. It is concluded that three areas stand out in need of further investigation. The taxonomical assessment of the genus is outdated and lacking. A revision is needed to account for intra- and inter-specific, geographical, and chemo-taxonomical variation, including variation in composition. Further research is needed to conclusively elucidate the active compound(s). Confounded by early substitution, intermixture, and blending, it has yet to be demonstrated beyond a reasonable doubt that both (or all) Harpagophytum spp. are equally (and interchangeably) safe and efficacious in clinical practice.

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“…Якщо гіпонатріємія є стійкою, можна дати хлорид натрію у формі пероральних таблеток солі або внутрішньовенне введення фізіологічного розчину. Таблетки солі також можуть бути поєднані з діуретиками, такими, як фуросемід (по 20 мг двічі на день), оскільки це сприяє зниженню концентрації сечі та, тим самим, збільшує екскрецію води, особливо серед пацієнтів, котрі мають осмолярність сечі набагато вище, ніж сироваткова осмолярність (більше 500 мОсм/кг) [14].…”

unclassified

Clinical and Pathogenetic Values of Hyponatryemia in Patients with Subarachnoidal Hemorrhage of Atramatic Genesis

Polkovnikova¹

2019

Ukr. ž. med. bìol. sportu

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Зв'язок роботи з науковими програмами, планами, темами. Робота є фрагментом НДР кафедри нервових хвороб ДЗ «Запорізька медична академія післядипломної освіти МОЗ України»: «Комплексна діагностика та алгоритми прогнозування перебігу субарахноїдальних крововиливів у хворих різних вікових груп», № держ. реєстрації 0115U000657. Актуальність. Субарахноїдальний крововилив (САК)-один з найтяжких типів порушень мозкового

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Syndrome of inappropriate antidiuretic hormone secretion induced by the phytotherapy Harpagophytum procumbers: case report

Cited by 5 publications

References 5 publications

Toxicology studies of aqueous-alcohol extracts of Harpagophytum procumbens subsp. procumbens (Burch.) DC.Ex Meisn. (Pedaliaceae) in female and male rats

Toxicology studies of aqueous-alcohol extracts of Harpagophytum procumbens subsp. procumbens (Burch.) DC.Ex Meisn. (Pedaliaceae) in female and male rats

From Bush Medicine to Modern Phytopharmaceutical: A Bibliographic Review of Devil’s Claw (Harpagophytum spp.)

Clinical and Pathogenetic Values of Hyponatryemia in Patients with Subarachnoidal Hemorrhage of Atramatic Genesis

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