13 March 2004
Dear Doctor,
Suspected Cases of Aristolochic Acid Poisoning
A case of suspected Aristolochic Acid (AA)���u���������������a��x ��p ���vpoisoning due to erroneous substitution of the herb Herba Solani Lyrati (��h ��p ��` ^) with Aristolochia mollissima Hance (��X M�����P ��` ��H ) was reported to the Department of Health in March 2004 by the Hospital Authority. Investigation revealed confusion in the terminology in 3 types of herbs, namely ��h ��p ��` ^, ��X M�����P ��` ��H and ��h ��p ��@ ��8 ������. Department of Health has called on the trade to suspend the sale of the above 3 herbs.
Inappropriate or long term use of AA-containing herbs or products is reported in the literature to be associated with Aristolochic Acid Nephropathy and urinary tract cancer. Examples of the more commonly used AA containing herbs include: Caulis Aristolochiae Manshuriensis (��������@ �����p q), Radix Aristolochiae Fangchi (��0 s�����` ��@ v), Fructus Aristolochiae (���������������a), Radix Aristolochiae (��0 C��@ �����` ��x ) and Herba Aristolochiae (��@ ��( ��h P������).
Please be aware and consider enquiring about the use of herbal medicines when patients present with nephropathy or urinary tract cancer of unknown origin. Please report highly suspected case to the Department of Health using the attached report form report form to facilitate further investigation.
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