On 25/9, Ninh Binh Obstetrics and Pediatrics Hospital reported that a two-year-old boy was admitted for emergency treatment after his family administered *loc mai* leaves for constipation. Approximately four days prior to admission, the child experienced constipation. Following folk tradition, the family prepared soup and a drink from *loc mai* leaves for him. About a day later, the child developed a continuous high fever, progressively worsening jaundice, and dark red urine, prompting the family to seek emergency care.

Following examination and tests, doctors diagnosed the child with severe anemia due to acute hemolysis, suspected to be linked to the *loc mai* leaves. The patient received treatment in the Intensive Care and Anti-Poisoning Department, including blood transfusions, fluid therapy, urine alkalization, and respiratory support.

The patient's health stabilized after four days of treatment. *Photo: Provided by the hospital*

In the initial days, the child continued to have a fever and dark urine. However, the anemia gradually improved, mucous membranes appeared pinker, and fever episodes became less frequent. The child is now breathing independently, with an SpO₂ of 98%, stable cardiovascular function, a soft abdomen, and mild jaundice. While urine remains dark, no related long-term complications have been observed.

*Loc mai*, also known by local names such as *rau mai* or *mo trang*, is a wild plant traditionally used in folk medicine as a laxative and to treat constipation. However, these leaves can be toxic if used improperly, particularly in large quantities or when prepared incorrectly.

Symptoms of *loc mai* poisoning can include fatigue, pale skin, abdominal pain, digestive issues, and red or dark urine. In severe cases, patients may develop acute hemolysis, significant anemia, and organ damage. The risk of severe outcomes is especially high for individuals with G6PD deficiency, whose red blood cells are more vulnerable to oxidative damage.

Acute hemolysis, characterized by the rapid destruction of red blood cells, leads to a sharp decline in their count. The byproducts of this destruction can also impair kidney function. Without prompt detection and treatment, patients risk liver and kidney damage, multi-organ failure, and life-threatening complications.

Doctors strongly advise against using *loc mai* leaves or other plants of unconfirmed safety to treat children's ailments based on folk remedies. For symptoms such as constipation, parents should seek medical consultation or take their child for an examination, rather than self-administering herbal treatments.

If a child develops fatigue, pale skin, jaundice, fever, abdominal pain, or dark red/brown urine after consuming any herbal leaves, parents must take them to a medical facility immediately. It is crucial to inform the doctor about the specific plant or leaves administered.

Le Hoang