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February 4, 2004

Chemical Composition of Chinese Star Anise (

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(5):562-563. doi:10.1001/jama.291.5.562

To the Editor: The spice Chinese star anise (Illicium verum f Hook) is used in many cultures. Caribbean and Hispanic cultures use a tea infusion of its star-shaped fruit as treatment for infant colic.1 A closely related species, Japanese star anise (Illicium anisatum L), however, has been reported to cause neurologic and gastrointestinal toxicities.1,2 Possible adulteration of I verum with I anisatum has led to recalls of these products in several countries.3 During the past 2 years at our institution, 7 cases of adverse neurologic reactions have been reported among infants aged 2 weeks to 3 months who were exposed to star anise tea. The presentation consisted of signs of acute-onset irritability, jitteriness, clonus or myoclonus, increased deep tendon reflexes, nystagmus, vomiting, and seizures. All of the cases had normal laboratory and electroencephalography findings. Symptoms in all of the cases resolved within 24 hours of presentation. None of the infants had further neurologic episodes at follow-up. We were able to obtain samples of the anise from 3 of these cases to determine whether they had been contaminated with I anisatum.

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