Essential oil poisoning: N-acetylcysteine for eugenol-induced hepatic failure and analysis of a national database
- 405 Downloads
We present a 15-month-old boy who developed fulminant hepatic failure after ingesting 10 ml of clove oil. After 24 h, the ALT level was in excess of 13,000 U/l, with blood urea and creatinine of 11.8 mmol and 134 µmol/l respectively. The hepatic impairment resolved after intravenous administration of N-acetylcysteine so that 6 h later, the ALT level was approximately 10,000 U/l. His liver synthetic function and clinical status improved over the next 4 days. This is the first such case report of its kind in Europe. Analysis of a national database revealed a 14-fold increase in home accidents related to aromatherapy from 1994–1999. Clove oil has important hepatotoxic effects. Conclusion:Recent growth in aromatherapy sales has been accompanied by an unfortunate increase in accidental poisoning from these products. Clove oil warrants special attention. Ingesting as little as 10 ml causes hepatotoxicity which can be treated with N-acetylcysteine.
KeywordsDatabase Essential oils Hepatic failure Home accidents Treatment
home accident surveillance system
disseminated intravascular coagulation
We thank Dr Derek Johnston for his permission to report this case.
- 1.Alternative Healthcare Market Assessment. Available online at:http://www.researchandmarkets.com/reportinfo.asp
- 2.Avery JG, Jackson RH (1993) Children and their accidents. Edward Arnold, London, pp 55–57Google Scholar
- 3.Brown SA, Biggerstaff J, Savidge GF (1992) Disseminated intravascular coagulation and hepatocellular necrosis due to clove oil. Blood coag and fibrinolysis; 3:655–658Google Scholar
- 4.Cutis EK (1990) In pursuit of palliation: oil of cloves in the art of dentistry. Bull History Dentistry 38: 9–14Google Scholar
- 5.Eisen JS, Koren G, Juurlink DN, Ng VL (2004) N-acetylcysteine for the treatment of clove oil-induced fulminant hepatic failure. J Toxicol Clin Toxicol 42: 89–92Google Scholar
- 8.Herb Information. Available online at:http://www.holistic-online.com/Herbal-Med/_Herbs/h218.htm
- 10.Lane BW, Ellenhorn MJ, Hulbert TV, McCarron M (1991) Clove oil ingestion in an infant. Hum Exp Toxicol 77: 137–47Google Scholar
- 14.Wetherall DJ, Ledingham JGG, Warrell DA (1996) Oxford textbook of medicine, 3rd edn. Oxford University Press, Oxford, pp 1051–1052Google Scholar