Acalypha indica induced acute oxidative haemolysis and methaemoglobinaemia: two case reports

BACKGROUND

Herbal products and traditional remedies are commonly used by individuals worldwide for the management of common ailments, even though most are not without risks. Acalypha indica is a popular medicinal plant consumed in some Asian countries.

CASE PRESENTATION

This case report presents a 40-year-old previously unevaluated Sri Lankan female and her 8-year-old son who presented with severe glucose-6-phosphate dehydrogenase (G6PD) deficiency related acute intravascular oxidative haemolysis and methaemoglobinaemia precipitated by Acalypha indica consumption, successfully managed with supportive care and blood transfusion.

CONCLUSIONS

This case highlights the potential hemolytic and methaemoglobinaemic effects of ingesting oxidant herbal products and the importance of considering such exposures in patients presenting with hemolysis and multiorgan involvement, particularly in communities where herbal product intake is popular. Healthcare providers should be aware of the risks associated with traditional remedies and maintain a high index of suspicion to ensure prompt recognition and appropriate management.

Toxicological evaluation of the aqueous extract of Acalypha wilkesiana in Wistar albino rats

BACKGROUND

Acalypha wilkesiana (Euphorbiaceae) is highly accepted for traditional treatment of human plasmodiasis in Africa.

METHODS

The toxicological effects of the aqueous leaf extract of A. wilkesiana were studied in 45 male and female Wistar albino rats. An acute toxicity testing was done using 21 rats divided into seven groups and LD50 determined. In the sub-chronic toxicity study, the extract was administered orally over a period of 28 days to rats in three groups with doses of 400 mg kg-1, 800 mg kg-1 and 1,600 mg kg-1, respectively, and the fourth group administered with water served as control. Blood samples were collected for hematological and serum biochemical analysis; organs of the animals were harvested for histopathological examination.

RESULTS

The acute toxicity testing showed that the extract was non-toxic at doses up to 3,000 mg kg-1 and the LD50 was calculated to be 2,828.34 mg kg-1. The study showed that at 1,600 mg kg-1 dose, the extract caused a decrease in the level of neutrophils (NEUT) while lymphocytes (LYMP) were statistically significantly increased. The administration of the extract also resulted in varying significant dose dependent increase in the levels of aspartate amino transferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP). There were also significant increases in the level of total protein (TP), urea (URN) and albumin (GLB) especially at 1,600 mg kg-1 dosage. Histopathology showed that the extract caused mild to severe significant lesions that are dose dependent in the liver and kidney when compared with the control group.

CONCLUSIONS

Prolonged administration of high dose of A. wilkesiana extract has tendency to cause organ toxicity.