Aristolochia tagala 印度馬兜鈴

Aristolochiaceae 馬兜鈴科

India Birthwort¹

耳葉馬兜鈴、卵葉馬兜鈴、鎚果馬兜鈴²

POISONOUS PARTS

TOXICITY

Toxic Constituents
Aristolochic acids.⁶
Mechanism
Aristolochic acids are nephrotoxic, leading to interstitial fibrosis and tubular atrophy. They have genotoxic and carcinogenic effects, which are related to the formation of aristolochic acid-DNA adducts.^6,7
Poisoning Features
Prolonged intake of aristolochic acid-containing herbs could cause aristolochic acid nephropathy, which is characterised by progressive interstitial fibrosis leading to renal failure and urothelial carcinoma.^6,7
Poisoning Events
Multiple cases of aristolochic acid nephropathy after intake of aristolochic acid-containing herbal medicine, either intentionally or mistakenly due to mixing up of herbs, have been reported worldwide. As a result, the use of these herbs is now banned in most countries.^6–8

CLINICAL MANAGEMENT

Supportive treatment. Steroid therapy has been proposed to slow down the progression of renal failure in aristolochic acid nephropathy.⁹

IDENTIFICATION FEATURES

Herbaceous vines; stems glabrous. Petiole 2–5.4 cm; leaf blades 8–12(–24) × 4–14(–20) cm, glabrous, base deeply cordate, palmately veined. Racemes 2–3-flowered. Perianth pale yellowish or greenish, tubes straight, utricle 5–8 mm in diameter; limb 2–3 × 0.6 cm, ligulate. Anthers ovoid, gynostemium 6-lobed. Capsules 3–5.5 × 2–3.5 cm. Seeds about 8 × 8 mm, subcordiform.¹⁰

MEDICINAL USES

The use of aristolochic acid-containing herbs has been banned.

CASES IN TRL

A. tagala poisoning has not been reported locally. However, TRL has diagnosed multiple cases of aristolochic acid nephropathy after using other aristolochic acid containing herbs in 2004. In a cluster of cases, the non-toxic Solanum lyratum had been mixed up with Aristolochia mollissima at the wholesaler level, probably related to the same Chinese common name, “Bai Mao Teng”, of both herbs. As a result, aristolochic acid containing herbs and products were banned in Hong Kong since 2004.⁷