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VOLUME 22 , ISSUE 6 ( 2018 ) > List of Articles


Hepatomyoencephalopathy secondary to Cassia occidentalis poisoning: Report of three cases from North India

Viswas Chhapola, Sandeep Kanwal

Keywords : Accidental poisoning, acute hepatomyoencephalopathy syndrome, Cassia occidentalis, phytotoxin, plant poisoning

Citation Information : Chhapola V, Kanwal S. Hepatomyoencephalopathy secondary to Cassia occidentalis poisoning: Report of three cases from North India. Indian J Crit Care Med 2018; 22 (6):454-456.

DOI: 10.4103/ijccm.IJCCM_85_18

License: CC BY-ND 3.0

Published Online: 01-03-2015

Copyright Statement:  Copyright © 2018; The Author(s).


Cassia occidentalis is an annual tropical shrub causing toxicity in cattle. However, human case reports of its poisoning are scarce. We, here, report three young children, residents of Western Uttar Pradesh in North India, who presented with lethargy, jaundice, and altered sensorium after consumption of Cassia seeds. The toxidrome was defined as hepatomyoencephalopathy. The children were resuscitated, managed for acute liver failure, and subsequently discharged without sequel. Although few studies have previously documented this association, this is the first such case series documenting a direct causal relationship of Cassia to hepatomyoencephalopathy syndrome. Public and clinician awareness regarding this syndrome mimicking viral encephalitis has the potential to prevent further outbreaks.

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