Psoralen
Common name
furocoumarin,Bol-gol-zhee,Bu-gu-zhi
ID
HD0052
Scientific name of the plant
Psoralea corylifolia
Anatomical part for use
seed
Human use
Skin disorders & minor wounds
Summary
Psoralea corylifolia (Babchi) is a plant used in Indian and Chinese traditional medicine. The seeds of this plant contain a variety of coumarins, including psoralen. (Source: Wiki)
Evidence Level
Level 4 (Individual reports repeated observed over 5 years among different countries)
Hepatotoxicity reports in literature
- Hepatitis from 5-methoxypsoralen occurring in a patient with previous flucloxacillin hepatitis : (Source)
- A case of acute cholestatic hepatitis associated with the seeds of Psoralea corylifolia (Boh-Gol-Zhee) : (Source)
- Liver injury associated with the use of Fructus Psoraleae (Bol-gol-zhee or Bu-gu-zhi) and its related proprietary medicine : (Source)
- A rare case of acute hepatitis induced by use of Babchi seeds as an Ayurvedic remedy for vitiligo : (Source)
- Fulminant hepatic failure after methotrexate and PUVA therapy for psoriasis : (Source)
Hepatotoxicity Description
In open label trials, serum
ALT
or
AST
elevations occurred in 2% to 12% of subjects treated with methoxsalen and UV light. The elevations were usually mild-to-moderate in severity, asymptomatic and self-limited in course. Clinically apparent acute liver injury has also been reported with oral methoxsalen therapy, but only in isolated case reports including one instance attributed to topical methoxsalen therapy. The time to onset has ranged from 1 to 5 months, the typical latency being 6 to 8 weeks. The onset is generally insidious, with appearance of nausea and abdominal pain followed by jaundice. Fever occurs in some cases, but rash and eosinophilia are not common. The typical pattern of injury is hepatocellular. Most published cases of psoralen hepatotoxicity have been mild-to-moderate in severity, but severe jaundice and death from hepatic failure has been described in patients with preexisting cirrhosis who developed further acute liver injury attributed to methoxsalen. Most cases resolve within 6 to 8 weeks.
Psoralen is also present in many herbal products used to treat various conditions including psoriasis and vitiligo. Case reports of acute liver injury have been reported with the use of seeds, powder and teas prepared from Psoralea corylifolia under various Chinese names such as Boh Gol Zhee, Xin Cu Hei Su and Qu Bai Ba Bu Gi Pian. Chemical analyses have shown the presence of psoralen in these products. The clinical features of these cases have resembled those attributed to methoxsalen with a latency of 1 to 2 months, a hepatocellular pattern of injury, absence of immunoallergic or autoimmune features, and self-limited course with recovery within 6 to 8 weeks. (Source: LiverTox)
Common name
furocoumarin,Bol-gol-zhee,Bu-gu-zhi
ID
HD0052
Scientific name of the plant
Psoralea corylifolia
Anatomical part for use
seed
Human use
Skin disorders & minor wounds
Summary
Psoralea corylifolia (Babchi) is a plant used in Indian and Chinese traditional medicine. The seeds of this plant contain a variety of coumarins, including psoralen. (Source: Wiki)
Evidence Level
Level 4 (Individual reports repeated observed over 5 years among different countries)
Hepatotoxicity reports in literature
- Hepatitis from 5-methoxypsoralen occurring in a patient with previous flucloxacillin hepatitis : (Source)
- A case of acute cholestatic hepatitis associated with the seeds of Psoralea corylifolia (Boh-Gol-Zhee) : (Source)
- Liver injury associated with the use of Fructus Psoraleae (Bol-gol-zhee or Bu-gu-zhi) and its related proprietary medicine : (Source)
- A rare case of acute hepatitis induced by use of Babchi seeds as an Ayurvedic remedy for vitiligo : (Source)
- Fulminant hepatic failure after methotrexate and PUVA therapy for psoriasis : (Source)
Hepatotoxicity Description
In open label trials, serum ALT or AST elevations occurred in 2% to 12% of subjects treated with methoxsalen and UV light. The elevations were usually mild-to-moderate in severity, asymptomatic and self-limited in course. Clinically apparent acute liver injury has also been reported with oral methoxsalen therapy, but only in isolated case reports including one instance attributed to topical methoxsalen therapy. The time to onset has ranged from 1 to 5 months, the typical latency being 6 to 8 weeks. The onset is generally insidious, with appearance of nausea and abdominal pain followed by jaundice. Fever occurs in some cases, but rash and eosinophilia are not common. The typical pattern of injury is hepatocellular. Most published cases of psoralen hepatotoxicity have been mild-to-moderate in severity, but severe jaundice and death from hepatic failure has been described in patients with preexisting cirrhosis who developed further acute liver injury attributed to methoxsalen. Most cases resolve within 6 to 8 weeks. Psoralen is also present in many herbal products used to treat various conditions including psoriasis and vitiligo. Case reports of acute liver injury have been reported with the use of seeds, powder and teas prepared from Psoralea corylifolia under various Chinese names such as Boh Gol Zhee, Xin Cu Hei Su and Qu Bai Ba Bu Gi Pian. Chemical analyses have shown the presence of psoralen in these products. The clinical features of these cases have resembled those attributed to methoxsalen with a latency of 1 to 2 months, a hepatocellular pattern of injury, absence of immunoallergic or autoimmune features, and self-limited course with recovery within 6 to 8 weeks. (Source: LiverTox)