Nephrotoxicity of Rubia Tinctorium

Sanae Ezzaki

Abstract

Introduction: Rubia tinctorum called in Morocco ELFOUA is a plant perennial of the family RUBIACEAE, used in Morocco for millennia as aperitif plant to grow, and in cases of anemia, to increase blood volume and improve skin tone or to facilitate childbirth in women. However, Rubia tinctorum is very rich in anthraquinone derivatives which can have a toxic effect especially on the kidney. Patients and methods: We report 3 cases of patients who presented acute renal failure following taking Rubia tinctorum, Results: Case 1: HE aged 15, without specific medical history, admitted to a glomerular syndrome due to kidney failure at 66 mg / L of plasma creatinine and 24-hour proteinuria at 1 g / 24 hours and aseptic leukocyturia occurred after taking Rubia tinctorum for ten days. 2nd case LN aged 39, without pathological antecedent, hospitalized at the nephrology department for glomerular syndrome is a 24h urine protein 2 g / 24 with severe acute kidney failure at 90 mg / L of plasma creatinine and aseptic leukocyturia without hematuria or hypertension in a context of uncontrollable vomiting after taking Rubia tinctorum 3rd case: Mrs. AH 47 years old, hospitalized in nephrology for acute renal failure at 73 mg / L of plasma creatinine discovered incidentally during a CPA balance for cholecystectomy with notion of taking Rubia tinctorum a week before admission. The patients underwent punctures renal biopsies that showed acute tubulointerstitial nephritis. Therapeutically they were put under corticosteroid with a good improvement creatinine. Discussion: In the literature, renal toxicity related to consumption elfoua has not been described in humans, but studies in rats have shown that the administration of this plant can cause tubular necrosis with nephritis interstitials. These effects were observed with the waning of chronic ingestion of large doses. Cases have been reported and recorded by the Pharmacovigilance Center of Morocco. Conclusion: The combination of histological lesions and the patient taken elfoua in this fact evoking its toxic effect on the kidney that is a limitation to the use of this plant despite therapy.