Fake case of Oriental medicine

The story

One family had a child with a severe skin disease. They lived in the USA then, and since treatments prescribed by modern, conventional medicine didn't work for the child the parents turned to "unconventional" solutions and received some preparations that cured the disease. Later the family moved to Israel and continued treatment in a local hospital. 

It was claimed that the formulations contain medical plant extracts prepared in China according to the knowledge of Traditional Chinese medicine. The preparations were prescribed for the treatment of skin diseases and allergic symptoms in children by naturopathic specialists in the USA. Israeli doctors did not buy the story and decided to check for the presence of steroids in preparations because these compounds can be harmful to children. Then our laboratory was contacted by a hospital and received three homeopathic formulations for analysis (a plant extract and two ointments). The LC-MS analysis did not reveal any steroids in these formulations but the attention was drawn by two compounds of clearly synthetic origin. How can synthetic compounds be present in natural homeopathic formulations? 

Further LC-MS study demonstrated that so-called “plant extract” contains Levocetirizine while Clotrimazole was found in one ointment. Both compounds are synthetic pharmaceuticals used for treatments of various skin diseases in adults and should be taken with the prescription of “conventional” doctors. It is clear now how “homeopathic” medicine was so successful in the treatment of skin diseases. 

Instrumental: Orbitrap Discovery hybrid FT mass spectrometer coupled with Accela UPLC (Thermo Scientific). The mass spectrometer was operated in positive ESI mode using scan and MSn options. Chromatographic separations were carried out using Gemini Hexyl-Phenyl column (2×150 mm, 3µ particle size, Phenomenex) using linear gradients of acetonitrile/water (with 0.1% AcOH).