Hemorrhagic Cystitis Induced by an Herbal Mixture

Maria Antonietta Catania, MD; Alessandro Oteri, PharmD; Paola Caiello, MD; Alessandra Russo, MD; Francesco Salvo, MD; Ettore Saffi Giustini, MD; Achille Patrizio Caputi, MD; Giovanni Polimeni, PharmD


South Med J. 2010;103(1):90-92. 

In This Article

Abstract and Introduction


A healthy 33-year-old woman consumed a slimming product containing a mixture of herbal remedies without seeking medical advice. Two months later, the patient had hemorrhagic cystitis and discontinued the herbal product. Symptoms spontaneously remitted in a few days. Four months later, she took the same herbal remedy and the hemorrhagic cystitis reappeared. She then consulted her general practitioner. A urine culture test was negative, and the patient was advised to discontinue the herb intake. Again, the cystitis resolved within a week. The product involved contains a mixture of herbs, some of which have been associated with adverse effects that might account for the symptoms reported in this case.


The use of herbal remedies has been increasing over the past decade in Western countries.[1,2] An important reason for their widespread use is the belief that their "natural" origin implies a better tolerability compared with conventional medicines.[3] As a result, patients may not spontaneously reveal their use to healthcare providers when asked for medication history or not consider them as a cause of the occurrence of adverse drug events.[4] The efficacy of herbal remedies in the treatment of several conditions is still controversial.[3] In addition, several publications have recently raised concerns about their safety profile.[5–8] Along with these considerations, we describe a case of hemorrhagic cystitis which occurred in a woman who had taken a product containing a mixture of several herbal remedies for weight loss.


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