Seven cases, similar to the Belgian cases, were identified in France, corresponding to exposure to botanical preparations contaminated with Aristolochia fangchi
from 1989 to 1992.
Joelle Nortier and colleagues found cancer in 18 of 39 Belgians who had been diagnosed with end-stage kidney failure caused by the Chinese herb Aristolochia fangchi
Instead of using Stephania tetrandra, the druggists had filled the pills with derivatives of the herb Aristolochia fangchi
, which has long been known to damage kidneys and to cause cancer in animals.
The specific components including Aristolochia fangchi
(Guang Fang Ji).
It has been reported that AA would have a significant risk factor for urothelial carcinoma, probably associated with the highest risk when the cumulative level exceeds 200 g crude drug of Aristolochia fangchi
(Nortier and Vanherweghem, 2002).