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Fatal poisoning of pregnant women by peganum harmala L.: A case reports

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ANNALS OF MEDICINE AND SURGERY
卷 68, 期 -, 页码 -

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ELSEVIER SCI LTD
DOI: 10.1016/j.amsu.2021.102649

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Peganum Harmala L.; Poisoning; Pregnant women; Intensive care unit; Case report; Morocco

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This case report describes a 20-year-old woman who suffered from acute kidney injury, cerebral ischemia, and bleeding due to intoxication with Peganum harmala L. The patient received early treatment, including intubation, ventilation, symptomatic treatment, and hemodialysis, leading to a favorable outcome with discharge after one and a half months. Doctors should be aware of the signs of P. harmala toxicity and initiate prompt and adequate management to improve prognosis.
Introduction: Peganum harmala L. is a cosmopolitan plant within the Mediterranean region. It's normally employed in ancient drugs in Morocco as sedative and abortifacient however exposes users to the danger of dose and poisoning. The medical specialty active compounds of this plant embody variety of carboline and quinazoline alkaloids accountable of its pharmacological and medical effects. Case report: We tend to report the case of a 20-year-old woman, intoxicated with the Peganum harmala L. On admission, she was shocked with agitation vomittiong and disturbances of consciousness. Laboratory tests showed anemia, thrombocytopenia, acute kidney disease, increase in transaminases and a positive plasma bHCG. Cerebral CT disclosed multiple areas of cerebral ischemia with subarachnoid hemorrhage, thoraco-abdominalpelvic CT scan showed an enlarged uterus, the location of an interior hemorrhage while not physiological condition sac and inhalation pneumonia. Early treatment was given, she was intubated, ventilated artificially and sedated, symptomatic treatment was received. Hemodialysis was needed for her renal failure and anuria. She was extubated after six days and discharged from the hospital after one month and a half. Conclusion: Doctors operating in areas where P. harmala is prescribed or used as an ancient medicine should recognize the signs and symptoms of its toxicity in order to treat and initiate prompt and adequate management. The prognosis is generally favorable, excessive use of high doses of P. Harmala L. can lead to fatal evolution.

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