Toxic myopathy induced by the ingestion of loquat leaf extract

Loquat ( Eriobotrya japonica ) belongs to the trees of the Rosaceae family. Loquat leaves are widely used in the preparation of oriental herbal teas. In folk medicine, the loquat leaves are used against various skin diseases, cough, nausea, and itching. Loquat leaves contain ursolic acid and oleanolic acid, which both have hypoglycaemic and antihyperlipidaemic effects in test animals.1–3 We present a patient with hypertriglyceridaemia, who after ingestion of loquat leaf extract had a remarkable decrease in triglycerides and an increase in high density lipoprotein (HDL). However, this benefit was accompanied by toxic myopathy, resembling the effect of HMG-CoA reductase inhibitors and fibric acid derivatives. A 39 year old man was found to have a high fasting triglyceride level on routine blood testing. The total cholesterol level was normal, and the HDL cholesterol was low. He was otherwise healthy and smoked one packet of cigarettes a day for 5 years. He did not take any drugs, and denied habitual alcohol …