Songpon GetsuwanPornthep TanpowpongSatariya TrakulsrichaiPattana SornmayuraSuporn TreepongkarunaFaculty of Medicine Ramathibodi Hospital, Mahidol UniversityMahidol University2022-08-042022-08-042021-01-01Journal of Tropical Pediatrics. Vol.67, No.1 (2021)14653664014263382-s2.0-85102909830https://repository.li.mahidol.ac.th/handle/20.500.14594/78788Cassia occidentalis toxicity is thought to be uncommon; however, several cases have been described with acute hepatomyoencephalopathy with a high-mortality rate. We report a previously healthy, 2-year-old girl who developed acute liver failure after fresh seed ingestion. Without a specific antidote, we decided to implement supportive measures and medications including lactulose, sodium benzoate and N-Acetylcysteine. The patient also experienced with cardiogenic shock and transient distal renal tubular acidosis, which were all spontaneously resolved. The liver chemistries returned to normal 3 months after the ingestion, without receiving liver assisted device or liver transplantation.Mahidol UniversityMedicineArticleSCOPUS10.1093/tropej/fmaa087