Acute kidney injury, oral mucositis and gastritis as complications of ingestion of papaya leaf juice extract in a patient presenting with dengue fever

Abstract

The use of crude leaf preparations from Carica papaya for increasing platelet count in patients with dengue fever is a popular self-treatment that is increasingly being observed recently. We report the case of a 62-year-old male who presented to our outpatient department for the evaluation of 4-day fever. In hospital diagnostic testing revealed dengue NS1 antigen enzyme-linked immunosorbent assay was positive, thrombocytopenia (platelet count 66,000/mm3), normal serum creatinine (0.96 mg/dl). Thereafter, since he was told that he was diagnosed to have dengue fever with thrombocytopenia, as per the advice given by a neighbour, he had consumed juice extracted from papaya leaves to 'increase the platelet count.' Six hours after ingestion, he had developed severe mucositis of oral cavity and severe gastritis, vomiting and loose stools. He became drowsy and irritable. Arterial blood gas analysis revealed mild metabolic acidosis, serum creatinine increased to 3.69 mg/dL. He was treated symptomatically with intravenous fluids and was carefully monitored in-hospital. Over the next 2 days, fever subsided, serum creatinine and platelet count became normal and he was discharged in a stable condition. The present case highlights the life-threatening complications that can result with the use of papaya leaf extract in the self-treatment of dengue fever.

Keywords

• acute kidney injury
• carica papaya
• dengue fever
• leaf extract
• oral mucositis
• treatment