Cholestatic hepatitis due to Ecballium elaterium ingestion

Ecballium elaterium is an herbaceous plant belonging to the Cucurbitaceae family. This plant is fairly common in the Mediterranean regions. It is frequently consumed in infusion, mixture of fruit or even in aerosol in cases of fever or flu. This plant is known for its respiratory and ocular toxicity. Hepatotoxicity has never been described in the literature. We report a case of acute cholestatic hepatitis due to Ecballium elaterium in a 39 years old patient, with no past medical history.

Ethnopharmacological survey of medicinal plants used in traditional medicine by the communities of Mount Hermon, Lebanon

ETHNOPHARMACOLOGICAL RELEVANCE

Medicinal plant species in Lebanon are experiencing severe threats because of various environmental conditions, human expansion footprints and recent growing global demand. Organized research and information on indigenous medicinal plants and knowledge have been very limited and little efforts have been invested to develop a complete inventory for native medicinal plants and associated traditional knowledge in the country. Recognized as a key biodiversity area of the Mediterranean Basin, Mount Hermon hosts important richness of medicinal plants that has been traditionally used in treatment of many illnesses since generations. Novel knowledge gathered by the present investigation is important in preserving indigenous knowledge of Mount Hermon community and revitalizing traditional herbal medicines.

MATERIAL AND METHODS

Ethnopharmacological information was collected by semi-structured interviews with 53 native informants (herbalists, traditional healers, midwives and local adult villagers) in 13 towns and villages surrounding Mount Hermon. The interviews were conducted through guided field visits and discussion groups whilst collecting plants specimens. Taxonomical identification of plant species was based on the determination keys of the "New Flora of Lebanon and Syria" and specimens were deposited at the herbarium of the Research Center for Environment and Development at Beirut Arab University.

RESULTS

The results obtained indicate that 124 plant species of Mount flora are still used in traditional medicine by the local communities as an important source of primary health care and treatment of a wide range of different illnesses. These species belonged to 42 families and 102 genera. Compositae (19 species), Labiatae (18 species), Rosaceae (11) and Umbelliferae (11) formed the dominant families. Informants' Consensus Factor (FIC) analysis revealed that among the 14 illness categories used, respiratory (0.94), gastrointestinal and renal (0.93), genital systems (0.92) had the highest FIC values. The Medicinal Importance (MI) of these systems had also the top positions (16.24, 13.60, 13.18 and 12.09, respectively), whilest Mentha spicata subsp. condensata (Briq.) Greuter et Burdet recorded the heighest Cultural Importance (CI) value at 4.75.

CONCLUSION

This study documents for the first time the ethnopharmacological knowledge regarding part of the Lebanese flora in Mount Hermon. The perpetuity of this knowledge of successive generations can be used as an important tool for the future phytochemical, pharmacological, and toxicological studies, as well as conservation and management of medicinal plants as part of the local cultural heritage.