A case of acute toxic hepatitis associated with Prangos ferulacea

INTRODUCTION: A fifty-nine-year-old female was also planned to present a case of acute toxic hepatitis, which is thought to be caused by herbal eating known as “heliz”. The plant is known as heliz (çaşır), leaf and stem are consumed in the plant “apiaceae” family, the Latin name is prangos ferulaceae. CASE: Fifty-nine year old female patient had eaten grass, known locally as “heliz”. After about an hour, the patient started complaining of abdominal pain, nausea and vomiting, and his complaints gradually increased. “He applied to the emergency department of Mus-Bulanik State Hospital. The patient was admitted to our clinic as a toxic hepatitis with elevated liver enzymes. In her physical examination, there was no feature other than epigastric tenderness. Her vital signs were normal. Laboratory findings at admission to our hospital were as follows: AST (aspartate aminotransferase): 430U / L, ALT (alanine aminotransferase): 412U / L, Total bilirubin: 0.11 mg / dl, Direct bilirubin: 0.02 mg / dl, GGT(gamma glutamyl transferase): 18 U / L, LDH (lactate dehydrogenase): 893 U / L, Alkaline Phosphatase: 72 U / L. Hemoglobin: 14.5 g / dl, Hematocrit: 44.5, White blood cell count: 6.9x103 / µL, Platelet count: 232x103 / µL, Prothrombin time (PT): 16.3 seconds, Activated partial thromboplastin time (Aptt): 37.7 seconds, INR (International normalization rate) were normal. She underwent cholecystectomy and her abdominal and doppler ultrasonography were normal.Viral hepatitis and autoimmune hepatitis antibodies were negative.After the patient was admitted to the hospital, she was treated with intravenous fluid and N-acetylcysteine and her clinical and laboratory findings resolved completely within one week. CONCLUSION: With its widely differing climatic, geographic and geologic zones, Turkey enjoys a rich and diverse flora. Apiaceae family is the eighth biggest families in the Flora of Turkey. And it is also one of the most important family in which there are many popular plants used as food and spices in Turkey because they carry essential oils. Growing in the eastern and southeastern regions of our country, the plant called “prangos ferulaceae” which is frequently consumed in the spring is known as “heliz” among the people. Although it is said that this plant has many benefits, we did not find any information in the literature related to the acute toxic hepatitis. In our case, we wanted to add this information to the literature because “acute toxic hepatitis” developed after consumption of this plant