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Previous Volume 349:1576-1577 October 16, 2003 Number 16 Next

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To the Editor: In 2001, the Food and Drug Administration (FDA) issued warnings and an import alert that herbal products are unsafe if they contain or are suspected to contain aristolochic acid.¹ A report in the Journal in 2000 described a cohort of 105 patients in whom rapidly progressive nephropathy developed after they had been given an herbal weight-loss product containing aristolochic acid by a Belgian clinic.² Because of a suspected association between aristolochic acid and urothelial carcinoma, 39 patients with end-stage renal disease underwent prophylactic removal of the kidneys and ureters; urothelial carcinoma was diagnosed in 18 of them. . . . [Full Text of this Article]

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