Severe hepatotoxicity following ingestion of Herbalife nutritional supplements contaminated with XXXX .

@entity1 @entity82 @entity96 @entity111 @entity1448 @entity56 @entity99 @entity3881
BACKGROUND/AIMS: Nutritional supplements are widely used. Recently, @entity99 after consumption of Herbalife preparations was reported but the underlying pathogenesis remained cryptic. METHODS: Two @entity1 presented with @entity1448 and @entity111 , and @entity82 , respectively. Viral, alcoholic, metabolic, autoimmune, @entity96 and synthetic drugs as the precipitating causes of @entity99 were excluded. However, both @entity1 reported long-term consumption of Herbalife products. All Herbalife products were tested for contamination with drugs, pesticides, heavy metals, and softeners, and examined for microbial contamination according to standard laboratory procedures. Bacteria isolated from the samples were identified as @entity3881 by sequencing the 16S rRNA and gyrB genes. RESULTS: Causality between consumption of Herbalife products and disease according to CIOMS was scored "probable" in both cases. Histology showed @entity1448 with @entity82 in one @entity1 , and @entity82 with ductopenia in the other. No contamination with chemicals or heavy metals was detected, and immunological testing showed no drug @entity56 . However, samples of Herbalife products ingested by both @entity1 showed growth of @entity3881 of which culture supernatants showed dose- and time-dependent hepatotoxicity. CONCLUSIONS: Two novel incidents of severe @entity99 following intake of Herbalife products contaminated with @entity3881 emphasize its potential hepatotoxicity.
