Hepatotoxicity caused by bay leaf (Laurus nobilis): A case report

Abstract

Introduction: In recent years, an increase in the use of herbal supplements, natural products, and traditional medicines has been observed. These herbs and herbal products have been associated with complications, such as liver injury, causing high mortality and morbidity.
 Case Report: A 51-year-old female presented to the emergency department with a 2-week history of abdominal pain, vomiting, and nascent jaundice. In the detailed history of the patient, the daily consumption of Laurus nobilis tea was reported for 1 month at home. On physical examination, she was icteric and ill-looking. Mild right upper quadrant discomfort with tenderness was noted, but no rash or hepatosplenomegaly was observed. The laboratory tests results were as follows: serum AST/ALT ratio 1.2 (908/744 U/L), gamma-glutamyl transferase 63 U/L, ALP 124 U/L, bilirubin (total/direct) 27.0/14.0 mg/dL, and lactate dehydrogenase 420 U/L. Prothrombin time international normalized ratio was 2.77. The gastroenterology department considered fulminant hepatitis in the patient and recommended liver transplantation. The patient died while preparations for the transplant were ongoing.
 Conclusion: Many herbal products are known to be hepatotoxic. Laurus nobilis is a commonly consumed herbal product, and the potential of this herb to cause hepatotoxicity should be considered.