Multiple Organ Failure After Ingestion of Pennyroyal Oil From Herbal Tea in Two Infants

PEDIATRICS ◽  
1996 ◽  
Vol 98 (5) ◽  
pp. 944-947 ◽  
Author(s):  
James A. Bakerink ◽  
Sidney M. Gospe ◽  
Robert J. Dimand ◽  
Marlowe W. Eldridge
Keyword(s):  
Hepatic Dysfunction ◽  
Epileptic Encephalopathy ◽  
Multiple Organ ◽  
Fulminant Liver Failure ◽  
Neurologic Injury ◽  
Herbal Tea ◽  
Toxic Agent ◽  
Potential Source ◽  
Minor Ailments ◽  
Possible Cause

Background Hepatic and neurologic injury developed in two infants after ingestion of mint tea. Examination of the mint plants, from which the teas were brewed, indicated that they contained the toxic agent pennyroyal oil. Methods. Sera from each infant were analyzed for the toxic constituents of pennyroyal oil, including pulegone and its metabolite menthofuran. Results. Fulminant liver failure with cerebral edema and necrosis developed in the first infant, who died. This infant was positive only for menthofuran (10 ng/mL). In the other infant, who was positive for both pulegone (25 ng/mL) and menthofuran (41 ng/mL), hepatic dysfunction and a severe epileptic encephalopathy developed. Conclusions. Pennyroyal oil is a highly toxic agent that may cause both hepatic and neurologic injury if ingested. A potential source of pennyroyal oil is certain mint teas mistakenly used as home remedies to treat minor ailments and colic in infants. Physicians should consider pennyroyal oil poisoning as a possible cause of hepatic and neurologic injury in infants, particularly if the infants may have been given home-brewed mint teas.

A novel ITPA variant causes epileptic encephalopathy with multiple-organ dysfunction

2020 ◽  
Vol 65 (9) ◽  
pp. 751-757 ◽  
Author(s):  
Masamune Sakamoto ◽  
Den Kouhei ◽  
Muzhirah Haniffa ◽  
Sebastián Silva ◽  
Mónica Troncoso ◽  
...  
Keyword(s):  
Organ Dysfunction ◽  
Epileptic Encephalopathy ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction

scholarly journals The Potential Roles of Cervical Plexus Abnormalities in Occipital Neuralgia: An Anatomic Variant Explored

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 139
Author(s):  
Mitchell H. Mirande ◽  
Heather F. Smith
Keyword(s):  
Clinical Significance ◽  
Degenerative Changes ◽  
Clinical Implications ◽  
Occipital Neuralgia ◽  
Cervical Plexus ◽  
Anatomical Variant ◽  
Occipital Nerve ◽  
Potential Source ◽  
Greater Occipital Nerve ◽  
Possible Cause

Occipital neuralgia (ON) is a condition defined as a headache characterized by paroxysmal burning and stabbing pain located in the distribution of the greater occipital nerve (GON), lesser occipital nerve (LON), or third occipital nerves (TON). This condition can be severely impairing in symptomatic patients and is known to have numerous etiologies deriving from various origins such as trauma, anatomical abnormalities, tumors, infections, and degenerative changes. This study reports four cases of a previously undescribed anatomical variant in which the (spinal) accessory nerve (SAN) fuses with the LON before piercing the sternocleidomastoid (SCM). The fusion of these two nerves and their route through the SCM points to a potential location for nerve compression within the SCM and, in turn, another potential source of ON. This anatomical presentation has clinical significance as it provides clinicians with another possible cause of ON to consider when diagnosing patients who present with complaints of a headache. Additionally, this study explores the prevalence of piercing anatomy of the LON and GAN and discusses their clinical implications.

scholarly journals Yogi Detox Tea: A Potential Cause of Acute Liver Failure

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Keerthana Kesavarapu ◽  
Mitchell Kang ◽  
Jaewook James Shin ◽  
Kenneth Rothstein
Keyword(s):  
Liver Failure ◽  
Laboratory Tests ◽  
Literature Search ◽  
Healthcare Professionals ◽  
Fulminant Liver Failure ◽  
Symptom Development ◽  
Ultrasound Guided ◽  
Herbal Tea ◽  
Liver Tests ◽  
Scleral Icterus

We present a case of acute fulminant liver failure from a liver detoxification tea. We present a 60-year-old female with weakness, lethargy, scleral icterus, jaundice, and worsening mental status. She drank herbal tea three times a day for 14 days prior to symptom development. Liver tests were elevated. Remaining laboratory tests and imaging were negative for other etiologies. An ultrasound-guided liver biopsy showed submassive necrosis. A literature search on the ingredients shows six ingredients as having hepatotoxic effects and remaining ingredients as having very sparse hepatoprotective data. Healthcare professionals should discuss herbal medication and tea use and report adverse effects.

LEVETIRACETAM AS A POSSIBLE CAUSE OF FULMINANT LIVER FAILURE

Neurology ◽  
2008 ◽  
Vol 71 (9) ◽  
pp. 685-686 ◽  
Author(s):  
T.C.H. Tan ◽  
B. W. de Boer ◽  
A. Mitchell ◽  
L. Delriviere ◽  
L. A. Adams ◽  
...  
Keyword(s):  
Liver Failure ◽  
Fulminant Liver Failure ◽  
Possible Cause

scholarly journals TLR4-NLRP3-GSDMD-Mediated Pyroptosis Plays an Important Role in Aggravated Liver Injury of CD38-/- Sepsis Mice

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Huiqing Zhang ◽  
Yuna Du ◽  
Yujie Guo ◽  
Zeyu Wang ◽  
Hua Li ◽  
...  
Keyword(s):  
Liver Injury ◽  
Western Blot ◽  
Bacterial Infection ◽  
Hepatic Dysfunction ◽  
Bacterial Culture ◽  
Multiple Organ ◽  
Hematoxylin And Eosin ◽  
Bacterial Stimulation ◽  
Deficient Mice

Clinically, severe bacterial infection can cause septicemia and multiple organ dysfunction syndrome, especially liver injury. CD38 is closely related to many inflammatory pathways, but its role in liver injury caused by bacterial infection remains unclear. The purpose of this study is to discuss the specific role of CD38 in bacterial liver injury. Eight-week-old male C57BL/6 mice (WT, CD38-/- and CD38-/-TLR4mut) were used and stimulated with Escherichia coli (ATCC25922) or PBS, intraperitoneally. After 3 hours of bacterial stimulation, serum was collected to detect ALT and AST concentration, and liver tissue was harvested for hematoxylin and eosin staining and bacterial culture. The mRNA expressions of TLR4, NLRP3, IL-1β, IL-18, and GSDMD were quantitatively determined by RT-qPCR. The expressions of TLR4, MyD88, TRIF, NF-κB p65, NLRP3, GSDMD, and cytokines were detected by Western blot. The expression and localization of ERK1/2 were detected by immunohistochemistry and Western blot. The results showed that bacterial stimulation could upregulate the expression of inflammatory cytokines, leading to hepatic dysfunction. Moreover, bacterial stimulation of CD38-deficient mice can aggravate the inflammatory response, the expressions of TLR4, NF-κB, and ERK1/2 were significantly increased, and the biomarkers related to pyroptosis also manifested more obvious pyroptosis. However, TLR4 mutation significantly alleviated inflammation and pyroptosis in the liver caused by bacteria, on the basis of CD38 deficiency. Overall, CD38 knockout exacerbates bacteria-induced liver damage through TLR4-NLRP3-GSDMD-mediated pyroptosis.

Imbalance in Brush Border Enzyme Activities as a Possible Cause of Hepatic Dysfunction after Jejunoileal Bypass in the Rat

1981 ◽  
Vol 13 (6) ◽  
pp. 427-437
Author(s):  
J. Marescaux ◽  
C. Stock ◽  
M. Vasseur ◽  
F. Raul ◽  
M. Doffoel ◽  
...  
Keyword(s):  
Brush Border ◽  
Enzyme Activities ◽  
Hepatic Dysfunction ◽  
Jejunoileal Bypass ◽  
Brush Border Enzyme ◽  
Possible Cause

scholarly journals Clinical and Immunomorphological Features of Liver Damage in Severe Preeclampsia

2020 ◽  
Vol 75 (5) ◽  
Author(s):  
Iraida S. Sidorova ◽  
Natalya A. Nikitina ◽  
Mikhail B. Ageev ◽  
Albert A. Kokin
Keyword(s):  
Liver Damage ◽  
Liver Tissue ◽  
Hepatic Dysfunction ◽  
Clinical Symptoms ◽  
Morphological Changes ◽  
Multiple Organ ◽  
Main Group ◽  
Severe Preeclampsia ◽  
Neuroendocrine Cells ◽  
Cd 34

Background.Liver diseases associated with pregnancy are recorded in 0.73% of pregnant women, often accompanied by the development of hepatic dysfunction/insufficiency, and are the cause of increased morbidity and mortality in both mother and child. A pathomorphological study helps to understand the pathophysiology of severe liver damage in preeclampsia, and to optimize the management of such patients.Aims to study the clinical, morphological and immunohistochemical features of liver tissue lesions in the most severe forms of preeclampsia and eclampsia, which ended in death.Methods.Autopsy material analysis of 10 patients who died from preeclampsia, eclampsia and their complications (main group) and 3 patients who died from other causes (comparison group). Pathomorphological and immunohistochemical studies of organs and tissues (in particular, liver tissue) were performed using a marker of neurons and neuroendocrine cells -NSE and a marker of endotheliocytes CD-34.Results.An immunohistochemical study with a CD-34 endotheliocyte marker in the main group revealed a vascularization deficiency in the 2nd and 3rd zone of hepatic acini, there were also foci of necrosis. Such changes indicate deep and prolonged hypoperfusion. The use of the NSE marker in the group of patients who died from preeclampsia/eclampsia revealed a sharp increase in Kupffer cells in the first and second zones of acini with pronounced immunoexpression of NSE in the nuclei and cytoplasm of these cells, which indicates severe hepatic dysfunction (in particular, impaired detoxification and elimination functions of the liver). At the same time, only 3 out of 10 women in the main group are clinically registered with HELLP syndrome, while the rest had signs of multiple organ (including acute liver) failure.Conclusions.The clinical symptoms of liver damage, including those with severe preeclampsia, arise, as a rule, already against the background of severe morphological changes in its tissue and, as a rule, indicate functional decompensation. Liver immunology remains little studied, which requires further research on this problem.

Kidney damage in COVID-19 patients

2021 ◽  
Vol 11 (3) ◽  
pp. 235-240
Author(s):  
Aleksei V. Antonov ◽  
Anton S. Vorob'ev
Keyword(s):  
Multiple Organ Failure ◽  
Renal Dysfunction ◽  
Organ Failure ◽  
Cause Of Death ◽  
Multiple Organ ◽  
Kidney Damage ◽  
Case Histories ◽  
Terminal Stage ◽  
Convoluted Tubules ◽  
Possible Cause

The results of the analysis of case histories of 100 deceased patients (55 women and 45 men), whose cause of death was the syndrome of multiple organ failure due to COVID-19, are presented. The case histories of patients who had no previous renal dysfunction were selected for the analysis. The average age of the patients was 76 years. At the terminal stage of the disease, microhematuria was detected in 27 patients, hypercreatininemia was noted in 17 patients, while the creatinine content in the blood did not exceed 437 mol / L in any of 100 patients. Oliguria was observed in 9 patients, polyuria in 43 patients. A possible cause of kidney damage is the damaging effect of SARS-CoV-2 on the proximal convoluted tubules of the nephron. At the same time, in no patient with a severe course of COVID-19, kidney damage did not determine the severity of the condition and was not the cause of death.

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