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El Nov 26, 2003 6:39 pm, text-conference 25 November dijo:
(gtorres> hello dr. Cosyns
(MJesus> if you like we could start a resume of your conference....
(JPCosyns> hello Dr torres
(JPCosyns> OK
(|> Aristolochic acid (formerly Chinese herbs) nephropathy
(|> Cosyns Jean-Pierre, MD PhD
(|> Department of Pathology, Medical School, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
(|> A rapidly progressive interstitial fibrosing nephropathy frequently associated with urothelial cancer has been reported in a series of young Belgian women given slimming pills containing ................
(|> _______ resume is over_________
(Anon774> thanks you very much!
(|> questions and commentary please....
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(gtorres> have you worked with prof. de broe?
(balas> There are many more such bad native drugs I am sure which have not been proven bad yet.
(MJesus> do this chinal herbs forbiden im Belgium Dr. Cosyns ?
(balas> Unfortunate that people develop fancy to these quakery
(JPCosyns> I have discussed this matter with Prof De broe but we had no actual collaboration on the subject.
(MJesus> I have notice a discussion about chinese herb in the nephro-l mailing list ...
(JPCosyns> These herbs are forbidden in pharmacies. however, I am afraid thay are still available outside over the counter.
(Pedro> here, in Sapain, these herbs ara forbiden,
(MJesus> popular gin seng are included ?
(JPCosyns> There are likely other drugs which are toxic as many cases have been reporte drecently in Asia (China and Japan). The etiologic substances have not yet been identified.
(JPCosyns> Popular Gin Seng is not included.
(balas> Dr.Cosyns, what is your impression about Rhubarb, another chinese drug
(Pedro> but people can buy them from street merkats
(JPCosyns> I have read in the past about the toxicity of rhubarb. As far I remember, the toxicity was not obvious but I should check this again.
(balas> There was some scientific positive feedbacks for rhubarb. Including KI
(balas> bur I don't hear much about it now
(MJesus> KI ?
(parmar> KI is kidney International,
(Pedro> How people can take this kind of herbs?, as a drug therapy?, out of medical control? or as hyothetical slim drugs out of professional control?
(balas> Yes there was an discussion by the chinese author in Kidney Int
(MJesus> ah ok
(parmar> Rhubarb is rich source of oxalate and it may the oxalate deposition that might be responsible for some 'interstitial nephhritis'
(balas> Is it Dr.Malwinder Parmer?
(parmar> Yes.
(MJesus> and in the nephro-l mailing list
(JPCosyns> Those harbs can be purchased without control. Herbal drugs are considered food supplements and there is no legislation regarding testing for side effects and toxicity for those products as is the case for Western drugs.
(parmar> Today I was able to join in
(gtorres> patron of interstitial fibrosis is only seen in the herbe Chinese?
(balas> There may good ones among the herbs too. But one need to systematically study them before unleashing on the unsuspecting public
(JPCosyns> I remember indeed a case of interstitial nephritis with extensive deposition of oxalate due tot he excessive consumption of rhubarb.
(JPCosyns> There are indeed non yoxic herbs. This is the reason why we have proposed to abandon the original designation of the disease as Chinese ehrbs nephropathy. This may be misleading as all Chinese herbs are not toxic. Since we have identified the culprit, aristolochic acid, we have proposed to rename the disease aristolochic acid nephropathy. This is more scientific and less prejudicial to the Chinese medicine in general.
(|> Dr. Cosyns, are you a pathologist or nephrologist ?
(MJesus> I like to ask a matter to Dr. Cosyns:
(JPCosyns> I am a pathologist
(MJesus> Dr Cosyns, you probably do not know about our Diagnostic Image Forum. It is a discussion forum in pathology., at http://pat.uninet.edu. Up to date, we had one only nephropathology case
(gtorres> is there asociation valvular cardiac pathologic and herbal chinese?
(MJesus> I'm also a pathologist, as Dr, Felix and Dr, Sanchez....
(MJesus> we are very intereste about to know more about this lession
(JPCosyns> Nice to meet you as a colleague in pathology.
(MJesus> and we like to ask you a case of chinese herb for the forum: we would be pleased in discussing some of your cases
(MJesus> delighted to meet you!
(parmar> Somehow got disconnected and joined again. Initially went on some different page. sorry!
(MJesus> more of 1500 pathologist, from 4 mailing list read every case of this foro ( 600 + 700 + 150 + 90)
(JPCosyns> Several patients with AAN/CHN have heart murmurs. It was first hypothesized that this was to the toxicity of Aritolochic acid. Actually, the cardiac valvular retractions are ascribed to the toxicity of fenfluramine , a serotoninergic drug that was prescribed simultaneously to the patients together with the herbs.
(gtorres> thanks
(MJesus> the majority are from latin-america (including brazil)
(JPCosyns> I will be delighted to discuss cases f AAN/CHN at your pathology forum.
(MJesus> Dr. parmar, if you try http://irc.uninet.edu instead webchat.uninet.edu you entry in this channel directly
(MJesus> thanks Dr. Cosyns!!
(MJesus> we hope so
(MJesus> (only need some clinica data and the microph you choose)
(JPCosyns> I thank you very much for your invitation. Bye bye.
(MJesus> more questions and commentary ?
(MJesus> indeed.... is there are not more question, we could try the next conference
(gtorres> bye dr. Cosyns
(JPCosyns> Bye and best wishes.
(MJesus> a toute a l'heure!
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