A Surviving Child from Acute Liver Failure after an Ingestion of Cassia occidentalis Seeds

• Main Authors: Songpon Getsuwan, Pornthep Tanpowpong, Satariya Trakulsrichai, Pattana Sornmayura, Suporn Treepongkaruna
• Other Authors: Faculty of Medicine Ramathibodi Hospital, Mahidol University
• Format: Article
• Published: 2022
• Subjects: Medicine
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/78788
• Institution: Mahidol University

Cassia occidentalis toxicity is thought to be uncommon; however, several cases have been described with acute hepatomyoencephalopathy with a high-mortality rate. We report a previously healthy, 2-year-old girl who developed acute liver failure after fresh seed ingestion. Without a specific antidote, we decided to implement supportive measures and medications including lactulose, sodium benzoate and N-Acetylcysteine. The patient also experienced with cardiogenic shock and transient distal renal tubular acidosis, which were all spontaneously resolved. The liver chemistries returned to normal 3 months after the ingestion, without receiving liver assisted device or liver transplantation.