Year 2016 / Volume 108 / Number 12
Case Report
Liver failure secondary to poisoning by a homemade product made of star and green anise in a 4-month-old infant

819-821

DOI: 10.17235/reed.2016.3964/2015

Pablo Obando Pacheco, Patricia Luisa Martínez-Martínez, Yolanda Pérez de Eulate Bazán, José Luis de la Mota Ybancos, Guillermo Milano Manso, Carlos Sierra Salinas,

Abstract
Intoxications in pediatric age represent a frequent cause of visit to the hospital emergency unit. Herb-made products can be toxic for the infant. The neurotoxic properties of the star anise (Illicium verum) have been widely described, although it is a classic product used to treat the infantile colic. Hepatic failure due to the consumption of anise herb elaborated infusions is presented as an exceptional finding in our environment. A case of a 4-month-old infant with hypertransaminasemia, severe coagulopathy, non ketotic hypoglycemia, moderated metabolic acidosis and neurologic symptoms such as seizures and nistagmus is described. After discarding infectious, metabolic and autoimmune etiology and through a meticulous anamnesis, the family referred having administered in the last two months a daily star anise and green anise (Pimpinella anisum) infusion to the patient. It is important to emphasize the serious risk of administering homemade herb infusions to infants.
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References
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Food and Drug Administration. FDA warns consumers about star anise teas. FDA Consum. 2003; 37: 4
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Gil Campos M, Pérez Navero JL, Ibarra De La Rosa I. Crisis convulsiva secundaria a intoxicación por anís estrellado en un lactante. An Esp Pediatr 2002; 57: 366-8
Perret C, Tabin R, Marcoz JP, et al. Apparent life-threatening event in infants: think about star anise intoxication. Arch Pediatr 2011; 18: 750-3
Ocete Hita E, Martín García JA, Giménez Sánchez F, et al. Hepatotoxicidad por fármacos o productos naturales en niños. An Pediatr 2013; 78: 248-59
Informe del Comité Científico de la Agencia Española de Seguridad Alimentaria y Nutrición (AESAN) sobre los riesgos asociados al consumo de anís estrellado en forma de infusión en la población infantil. AESAN-2009-015
Nakagawa Y, Suzuki T. Cytotoxic and xenoestrogenic effects via biotransformation of trans-anethole on isolated rat hepatocytes and cultured MCF-7 human breast cancer cells. Biochem Pharmacol 2003; 1; 66: 63-73
Wang GW, Hu WT, Huang BK, et al. Illicium verum: a review on its botany, traditional use, chemistry and pharmacology. J Ethnopharmacol 2011; 14;136:10-20
Okuyama E, Nakamura T, Yamazaki M. Convulsants from star anise (Illicium verum Hook.F.) Chem Pharm Bull 1993; 41: 1670-1
García-Cortés M, Fernández-Castañer A. Hepatotoxicidad por productos de herboristería. Rev Esp Enferm Dig 2013; 105 (7):433
Barrueto F Jr, Gattu R, Mazer-Amirshahi M. Updates in the general approach to the pediatric poisoned patient. Pediatr Clin North Am 2013; 60: 1203-20
Garzo Fernández C, Gómez Pintado P, Barrasa Blanco A, et al. Casos de enfermedad de sintomatología neurológica asociados al consumo de anís estrellado empleado como carminativo. An Esp Pediatr 2002; 57: 290–4
Ize-Ludlow D, Ragone S, Bruck IS, et al. Neurotoxicities in infants seen with the consumption of star anise tea. Pediatrics 2004; 114: 653-6
Madden GR, Schmitz KH, Fullerton K. A case of infantile star anise toxicity. Pediatr Emerg Care. 2012; 28: 284-5
Orden Ministerial 190/2004, 28 de enero. Lista de plantas cuya venta al público queda prohibida o restringida por razón de su toxicidad
Food and Drug Administration. FDA warns consumers about star anise teas. FDA Consum. 2003; 37: 4
De la Rubia Fernández L, Orizaola Ingelmo A, Hurtado Barace L, et al. Intoxicación por anís estrellado. An Pediatr 2009; 71: 581-2
Gil Campos M, Pérez Navero JL, Ibarra De La Rosa I. Crisis convulsiva secundaria a intoxicación por anís estrellado en un lactante. An Esp Pediatr 2002; 57: 366-8
Perret C, Tabin R, Marcoz JP, et al. Apparent life-threatening event in infants: think about star anise intoxication. Arch Pediatr 2011; 18: 750-3
Ocete Hita E, Martín García JA, Giménez Sánchez F, et al. Hepatotoxicidad por fármacos o productos naturales en niños. An Pediatr 2013; 78: 248-59
Informe del Comité Científico de la Agencia Española de Seguridad Alimentaria y Nutrición (AESAN) sobre los riesgos asociados al consumo de anís estrellado en forma de infusión en la población infantil. AESAN-2009-015
Nakagawa Y, Suzuki T. Cytotoxic and xenoestrogenic effects via biotransformation of trans-anethole on isolated rat hepatocytes and cultured MCF-7 human breast cancer cells. Biochem Pharmacol 2003; 1; 66: 63-73
Wang GW, Hu WT, Huang BK, et al. Illicium verum: a review on its botany, traditional use, chemistry and pharmacology. J Ethnopharmacol 2011; 14;136:10-20
Okuyama E, Nakamura T, Yamazaki M. Convulsants from star anise (Illicium verum Hook.F.) Chem Pharm Bull 1993; 41: 1670-1
García-Cortés M, Fernández-Castañer A. Hepatotoxicidad por productos de herboristería. Rev Esp Enferm Dig 2013; 105 (7):433
García-Cortés M, Fernández-Castañer A. Hepatotoxicidad por productos de herboristería. Rev Esp Enferm Dig 2013; 105 (7):433
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Obando Pacheco P, Martínez-Martínez P, Pérez de Eulate Bazán Y, de la Mota Ybancos J, Milano Manso G, Sierra Salinas C, et all. Liver failure secondary to poisoning by a homemade product made of star and green anise in a 4-month-old infant. 3964/2015


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Publication history

Received: 08/08/2015

Accepted: 02/10/2015

Online First: 15/02/2016

Published: 30/11/2016

Article revision time: 24 days

Article Online First time: 191 days

Article editing time: 480 days


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