Abstract
We report the case of a 69-year-old female with stage IIIB endometrial adenocarcinoma who developed an acute thrombocytopenia with greater than 90% decrease from her baseline value in platelets one day after a laparoscopic hysterectomy. Subsequently, the patient was found to have bilateral subsegmental pulmonary emboli and a right atrial thrombus. The thrombocytopenia reached a nadir of 31,000/mL3 from a baseline of 410,000/mL3 and resolved without intervention. Prior to the surgery, the patient was taking black seed oil, which is commonly used for its anti-carcinogenic effects, and evening primrose oil daily for approximately one month. A literature review revealed that black seed oil contains thymoquinone, which is a compound related to quinine. Evening primrose oil is also known to reduce platelet aggregation and has anti-thrombotic properties. We believe the patient’s thrombocytopenia was caused by a consumptive coagulopathy due to the formation of multiple thrombi and exacerbated by the use of herbal supplements, namely black seed and evening primrose oil.
Highlights
Thrombocytopenia is defined as a platelet count < 150,000/mL3, and is classified as mild, moderate (50,000-99,000/mL3), or severe (< 50,000/mL3)
We present a patient with significant acute postoperative thrombocytopenia after using black seed oil and primrose oil daily for one month
Animal studies have shown that ingestion of black seed oil or evening primrose oil decreased platelet counts in laboratory settings [2,3]
Summary
Thrombocytopenia is defined as a platelet count < 150,000/mL3 (normal range: 150,000-450,000/mL3), and is classified as mild (platelet count 100,000-150,000/mL3), moderate (50,000-99,000/mL3), or severe (< 50,000/mL3). Platelet transfusions are given to prevent bleeding if platelets are
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