Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Clin Cases. Sep 16, 2026; 14(26): 126744
Published online Sep 16, 2026. doi: 10.12998/wjcc.126744
Published online Sep 16, 2026. doi: 10.12998/wjcc.126744
Acute liver failure temporally associated with intensive consumption of Plantago major tea: A case report
Raul V Ponte, Department of Abdominal Transplant Surgery, Fortaleza General Hospital, Fortaleza 60822265, Ceara, Brazil
Anderson A Faria, Ludmila R Guedes, Francisco G Penna, João B Sancio, Alfa Institute of Gastroenterology, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte 30130100, Minas Gerais, Brazil
Isabela S Yamashiro, Maria L Macedo, Maria C Lima, Department of Surgery, School of Medicine, Federal University of Minas Gerais, Belo Horizonte 30130100, Minas Gerais, Brazil
Priscila F Souza, Department of Anesthesiology, School of Medicine, Federal University of Ceara, Fortaleza 60822265, Ceará, Brazil
Paula V Vidigal, Department of Pathology and Legal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte 30130100, Minas Gerais, Brazil
Co-corresponding authors: Raul V Ponte and João B Sancio.
Author contributions: Ponte RV and Sancio JB were the major contributors to the conception of the case report, retrospective review and interpretation of the clinical data, and drafting and critical revision of the manuscript; Faria AA, Guedes LR, Yamashiro IS, Macedo ML, Lima MC, Souza PF, Vidigal PV, and Penna FG contributed to patient care and clinical follow-up during hospitalization, intensive care, and outpatient follow-up, and assisted with data collection and review of the medical records; Vidigal PV contributed to the histopathological evaluation and interpretation; and all authors critically reviewed the manuscript, approved the final version, and agreed to be accountable for the work.
AI contribution statement: OpenAI ChatGPT was used as an assistive tool for language refinement, grammatical editing, and organization of the revised manuscript and responses to reviewers. All clinical data, scientific interpretations, references, and final manuscript content were independently reviewed and verified by the authors, who assume full responsibility for the accuracy and integrity of the work.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Raul V Ponte, MD, Department of Abdominal Transplant Surgery, Fortaleza General Hospital, 900 Riachuelo St, Fortaleza 60822265, Ceara, Brazil.
Received: August 13, 2026
Revised: September 7, 2026
Accepted: September 16, 2026
Published online: September 16, 2026
Processing time: 37 Days and 19.5 Hours
Revised: September 7, 2026
Accepted: September 16, 2026
Published online: September 16, 2026
Processing time: 37 Days and 19.5 Hours
Core Tip
Core Tip: This case describes acute liver failure temporally associated with intensive consumption of Plantago major tea in a previously healthy 44-year-old woman. After consuming approximately 2 L/day of prepared infusion for 15 consecutive days, she developed progressive hepatic dysfunction and grade III hepatic encephalopathy, ultimately requiring urgent liver transplantation. Explant histology demonstrated nonspecific massive hepatic necrosis and marked cholestasis. Although the temporal relationship raises suspicion for herb-induced liver injury, causality cannot be definitively established because the herbal preparation was not botanically authenticated or chemically analyzed.