Black seed oil induced acute liver failure: a case report and literature review

Acute liver failure (ALF) is a clinical condition that develops suddenly in individuals with no history of liver disease due to various factors and has a high morbidity and mortality rate. Drugs, chemicals, and herbal products are the leading causes of ALF. Black seed is widely used among the population due to its diuretic, antihypertensive, antidiabetic, anticancer, antimicrobial, anti-inflammatory, gastroprotective, hepatoprotective, kidney-protective, and antioxidant properties. In this report, an 82-year-old female patient with a history of diabetes, hypertension, and chronic kidney disease who received hemodialysis treatment twice a week was examined for ALF due to black seed oil use. The patient, who applied to the emergency room with confusion, had increased liver function tests in laboratory findings. In addition, no pathology was detected in the patient's CT angiography and ultrasonography other than grade 1 steatosis and increased linear echogenicity in the liver. The patient, who was diagnosed with ALF, started treatment in the intensive care unit. The patient, who had a poor prognosis in the intensive care unit, died on the 9th day of her hospitalization. Considering the studies in the literature and the patient we examined, although it is thought to be harmless among the public, herbal products should not be used with medications and in patients receiving renal replacement therapy without the advice of a physician or pharmacist due to their possible toxic effects.