Journal of Isfahan Medical School

Journal of Isfahan Medical School

Report of a case of pecan (Peganum harmala) poisoning: Evaluation of neurological symptoms and treatment.

Document Type : Case Report

Authors
1 Associate Professor of Clinical Toxicology, Department of Community Medicine, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
2 Student in General Medicine, Student Research Committee, Zabol University of Medical Sciences, Zabol, Iran
3 Assistant Professor of Clinical Immunology, Department of Immunology, Faculty of Medicine, Zabol University of Medical Sciences, Zabol, Iran
Abstract
Introduction
The use of herbal medicines in traditional Iranian medicine has recently gained public interest as an alternative to conventional modern medicine. However, neglecting the proper guidelines for these herbal treatments can result in serious issues, including severe poisoning. This article explores a case of poisoning induced by the oral consumption of Peganum harmala.
Methods
A 32-year-old woman experiencing symptoms such as nausea, vomiting, auditory and visual hallucinations, ataxia, and a distorted perception of time and space was transferred to the emergency room at Amir-al-momenin Hospital in Zabol. The medical team examined her, and diagnostic tests, along with a CT scan, were conducted.
Findings
The results from the patient's laboratory tests and CT scan were normal. The patient's medical history was reliable, and the clinical symptoms indicated poisoning from peganum. These symptoms were consistent with the effects of the alkaloids found in peganum, such as harmine and harmaline, which are known inhibitors of monoamine oxidase and acetylcholinesterase.
The patient was treated with diazepam and metoclopramide, and intravenous fluids were administered. The symptoms completely resolved after 24 hours, and the patient was discharged without any complications.
Conclusion
Consuming pecans improperly (orally) can lead to poisoning. This study highlights the critical importance of timely recognition of poisoning by medical teams, particularly regarding their accuracy and vigilance in managing patients with neuropsychiatric symptoms. Additionally, it emphasizes the need for education about the risks associated with the self-administration of herbal medicines.
Keywords
Subjects

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Volume 43, Issue 848
4th Week, March
March and April 2026
Pages 2054-2058

  • Receive Date 01 March 2025
  • Accept Date 21 February 2026