Severe Thrombocytopenia Associated With Black Seed Oil and Evening Primrose Oil

Abstract

We report the case of a 69-year-old female with stage IIIB endometrial adenocarcinoma who developed an acute thrombocytopenia with greater than 90% decrease from her baseline value in platelets one day after a laparoscopic hysterectomy. Subsequently, the patient was found to have bilateral subsegmental pulmonary emboli and a right atrial thrombus. The thrombocytopenia reached a nadir of 31,000/mL3 from a baseline of 410,000/mL3 and resolved without intervention. Prior to the surgery, the patient was taking black seed oil, which is commonly used for its anti-carcinogenic effects, and evening primrose oil daily for approximately one month. A literature review revealed that black seed oil contains thymoquinone, which is a compound related to quinine. Evening primrose oil is also known to reduce platelet aggregation and has anti-thrombotic properties. We believe the patient's thrombocytopenia was caused by a consumptive coagulopathy due to the formation of multiple thrombi and exacerbated by the use of herbal supplements, namely black seed and evening primrose oil.