우연한 협죽도(Nerium indicum) 복용에 의한 디지털리스양(digitalis-like) 중독 증상

Digitalis-like Toxic Symptoms Occurring after Accidental Nerium indicum Poisoning

  • 송예완 (아주대학교 의과대학 응급의학교실) ;
  • 안정환 (아주대학교 의과대학 응급의학교실) ;
  • 이정아 (아주대학교 의과대학 응급의학교실) ;
  • 김기운 (아주대학교 의과대학 응급의학교실) ;
  • 최상천 (아주대학교 의과대학 응급의학교실) ;
  • 정윤석 (아주대학교 의과대학 응급의학교실)
  • Song, Ye-Wan (Emergency Department, Ajou University, School of Medicine) ;
  • Ahn, Jung-Hwan (Emergency Department, Ajou University, School of Medicine) ;
  • Lee, Chung-Ah (Emergency Department, Ajou University, School of Medicine) ;
  • Kim, Gi-Woon (Emergency Department, Ajou University, School of Medicine) ;
  • Choi, Sang-Cheon (Emergency Department, Ajou University, School of Medicine) ;
  • Jung, Yoon-Seok (Emergency Department, Ajou University, School of Medicine)
  • 발행 : 2009.06.12

초록

Although Nerium indicum poisoning is a globally rare occurrence, Nerium oleander poisoning is known to occur frequently in the Mediterranean regions. To our knowledge, this is the first reported case of accidental Nerium indicum poisoning in Korea. Its poisoning symptoms and signs are similar to that of digitalis poisoning, because of the presence of cardiac glycosides in Nerium indicum. A 16-year-old boy was admitted to the emergency department four hours prior to the accidental ingestion of Nerium indicum petals. The patient complained of nausea, vomiting, and dizziness. His initial vital signs were stable; laboratory blood test results were within normal levels, except for the blood digoxin level (1.5 ng/dL). An electrocardiogram (ECG) analysis showed normal sinus rhythm, progressive PR prolongation and second-degree Morbiz type I AV block. Conservative treatments including activated charcoal administration were conducted, because toxic symptoms and signs were not severe. The patient was admitted to the intensive care unit for close observation. His ECG was converted to normal rhythm after 1 day and the toxic symptoms and signs were completely resolved after 4 days.

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