Carbamazepine‑Induced Hepato‑Renal Toxicity and the Protective Roles of Pomegranate Juice and Vitamin C in Female Albino Rats

To evaluate the effects of different doses of CBZ on hematological and histological parameters of liver and kidney in female albino rats, and to compare the protective roles of pomegranate juice and vitamin C. Materials and Methods: Sixty adult female albino rats were randomly divided into twelve groups (five rats each): control, pomegranate juice, vitamin C, three CBZ‑only groups (therapeutic, double and high dose), and six combination groups receiving CBZ with either pomegranate juice or vitamin C at the different CBZ doses. Treatments were given orally for eight weeks. Hematological parameters (WBC, lymphocytes, hemoglobin, platelets) and serum homocysteine were measured. At the end of the experiment, liver and kidney were collected, fixed in 10% formalin, processed for routine histology, and examined under a light microscope to assess structural alterations. Results: Rats treated with therapeutic, double, and high doses of CBZ showed a significant decrease in WBCs, lymphocytes and platelets compared with controls, while hemoglobin and homocysteine levels were not markedly affected. Histologically, CBZ caused dose‑dependent liver damage characterized by thickening of the liver capsule, hemorrhage, dilated sinusoids, hepatocyte hypertrophy with nuclear hyperchromasia, proliferation of Kupffer cells, inflammatory cell infiltration, and thrombus formation in the central vein. Kidney sections from CBZ‑treated groups revealed glomerular atrophy, widening of Bowman’s space, degeneration and desquamation of tubular epithelial cells, vascular congestion with degraded blood, and dense leukocytic infiltration in the interstitium. Co‑administration of pomegranate juice or vitamin C improved hematological indices and considerably restored liver and kidney architecture, with reduced inflammatory infiltration and structural degeneration. Overall, vitamin C produced slightly better histological protection than pomegranate juice, particularly at higher CBZ doses. Conclusion: Carbamazepine induces dose‑related hepato‑ and nephrotoxicity in female rats, while pomegranate juice and vitamin C attenuate these adverse effects through their antioxidant action, with vitamin C providing comparatively stronger protection.