Essential oil poisoning: N-acetylcysteine for eugenol-induced hepatic failure and analysis of a national database

Abstract

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.

Evaluation of the Toxicity of Eugenol at Anesthetic Doses in African Clawed Frogs (Xenopus laevis)

“…Urinary abnormalities occur with clove oil toxicity in children and include increased blood urea and creatinine levels, proteinuria, and hematuria (Brown et al 1992;Hartnoll et al 1993;Janes et al 2005;Lane et al 1991). In one report, these changes were hypothesized to be the result of direct nephrotoxicity of unchanged eugenol (Lane et al 1991).…”

“…Clove oil is sold over the counter for the relief of toothache or as an aromatherapy agent, and intoxications occur in children following accidental ingestion. Intoxication in children is usually manifested by central nervous system depression that can progress to coma, metabolic abnormalities including anion gap acidosis and hypoglycemia, severe hepatic failure, urinary abnormalities, and coagulation deficits (Brown et al 1992;Eisen et al 2004;Hartnoll et al 1993;Janes et al 2005;Lane et al 1991).…”

Acute Hepatitis Associated with Thymus Vulgaris Oil Ingestion; Case Report

“…It is considered to be highly toxic, and moreover, safety and efficacy have not been proven. [1,11,13,17] Two to three drops of thyme oil on a sugar cube 2 to 3 times on a daily basis were experimented. [1,12] Essential signs of toxicity included hypersensitivity reaction, nausea, vomiting, tachypnea and hypotension.…”

“…[17] On the other hand, Eugenol which is a component of thyme oil from Thymus capitatus, cilicus, funkii, and vulgaris, is hepatotoxic. [6,7,13] For instance, in children, as little as 10 ml of eugenol-containing clove oil has led to near fatal hepatic failure. [18] Our study had some limitations.…”

“…N-acetylcysteine 300 mg per hour (150 mg/kg, during 50 hours) for toxic hepatitis (for cases similar to essential oil or acetaminophen poisoning) and metoclopramide (10 mg) for recurrent vomiting were administered intravenously on the first and second days of patient observation. [13] During the observation period, his elevated aminotransferase levels (Table 1) and symptoms gradually decreased. No complications associated with hepatotoxicity were observed on his survey associated with hepatotoxicity and he was discharged with full recovery on the 9th day of his admission.…”