The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

Veratrum patulum intoxication developed in a group of twenty-three patients

집단으로 발생한 박새(Veratrum patulum) 중독 23예

  • Lee, Se-Hyung (Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung Asan Hospital) ;
  • Kim, Young-Don (Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung Asan Hospital) ;
  • Ha, Dong-Cheon (Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung Asan Hospital) ;
  • Han, Koon-Hee (Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung Asan Hospital) ;
  • Jeong, Woo-Jin (Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung Asan Hospital) ;
  • Kang, Hui-Dong (Department of Emergency Medicine, University of Ulsan College of Medicine, Gangneung Asan Hospital) ;
  • Cheon, Gab-Jin (Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung Asan Hospital)
  • 이세형 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 김영돈 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 하동천 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 한군희 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 정우진 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 강희동 (울산대학교 의과대학 강릉아산병원 응급의학과학교실) ;
  • 천갑진 (울산대학교 의과대학 강릉아산병원 내과학교실)
  • Received : 2009.08.28
  • Accepted : 2009.10.13
  • Published : 2010.10.01
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Abstract

Veratrum patulum is a perennial plant with toxicity, which grows wild in the high mountain areas of Korea. Various types of steroidal alkaloids contained in Veratrum patulum are known to cause symptoms such as nausea, vomiting, bradycardia and hypotension. Twenty-three patients were admitted to our center with chief complaints of nausea and vomiting after ingesting leaves of Veratrum patulum. The mean age of the group was 44 years old and was comprised of 19 males and 4 females. Some patients showed hypotension and bradycardia with symptoms such as dizziness. Ten patients with severe bradycardia coupled with other symptoms received atropine administration. Nausea and vomiting were improved after the administration of anti-emetics. Blood pressure and the pulse rate were all normalized on the day after admission, and all of the patients were discharged without any symptoms.

고산 지대에서 임의로 산나물을 채취하여 먹은 후 구역, 구토 등을 호소하며 저혈압 및 서맥을 보이는 경우 임상적으로 박새 중독을 의심하여야 하며, 진단 후에는 입원 상태에서 면밀한 생체 징후 감시와 적절한 보존적 치료를 시행한다면 빠른 시일 내에 회복될 수 있다. 저자들은 박새 잎을 섭취 후 집단으로 구토와 서맥, 저혈압 등의 중독 증상을 보인 23명의 환자들을 아트로핀 정맥 주사와 대증요법을 통해 치료한 예를 경험하였기에 보고하는 바이다.

Keywords

References

  1. Rim KH, Chung BS. Anatomical study of Veratrum coreanum Loes: Fil and veratrum plants. J of Plant Biol 6:18-20, 1963
  2. Lee NS. A taxonomic study of Korean veratrum. Korean J Plant Tax 15:49-65, 1985 https://doi.org/10.11110/kjpt.1985.15.1.049
  3. 신상윤, 이은규, 최재웅, 조용범, 유승기. 일가족에서 발생한 박새풀 중독의 5예. 대한내과학회지 70(Suppl):S212-S215, 2006
  4. Grancai D, Grancaiova Z. Veratrum alkaloids: I. Ceska Slov Farm 43:147-154, 1994
  5. Gaillard Y, Pepin G. LC-EI-MS determination of veratridine and cevadine in two fatal cases of Veratrum album poisoning. J Anal Toxicol 25:481-485, 2001 https://doi.org/10.1093/jat/25.6.481
  6. Clozel JP, Pisarri TE, Coleridge HM, Coleridge JC. Reflex coronary vasodilatation evoked by chemical-stimulation of cardiac afferent vagal C fibers in dogs. J Physiol 428:215-232, 1990 https://doi.org/10.1113/jphysiol.1990.sp018208
  7. Hainsworth R. Reflexes from the heart. Physiol Rev 71:617-658, 1991 https://doi.org/10.1152/physrev.1991.71.3.617
  8. Aviado DM, Guevara Aviado D. The Bezold-Jarisch reflex: a historical perspective of cardiopulmonary reflexes. Ann N Y Acad Sci 940:48-58, 2001
  9. Jaffe AM, Gephardt D, Courtemanche L. Poisoning due to ingestion of Veratrum viride (false hellebore). J Emerg Med 8: 161-167, 1990 https://doi.org/10.1016/0736-4679(90)90226-L
  10. Schuetz E, Adams J. Multi-system toxicity from intentional hellebore ingestion. Clin Toxicol 36:454, 1998
  11. Quatrehomme G, Bertrand F, Chauvet C, Ollier A. Intoxication from Veratrum album. Hum Exp Toxicol 12:111-115, 1993 https://doi.org/10.1177/096032719301200203
  12. Currens JH, Myers GS, White PD. The use of protoveratrine in the treatment of hypertensive vascular disease. Am Heart J 46: 576-592, 1953 https://doi.org/10.1016/0002-8703(53)90068-4
  13. Beasley J, Robinson K. Intolerance to veriloid. Br Med J 1:316-317, 1954 https://doi.org/10.1136/bmj.1.4857.316
  14. Zagler B, Zelger A, Salvatore C, Pechlaner C, De Giorgi F, Wiedermann CJ. Dietary poisoning with Veratrum album: a report of two cases. Wien Klin Wochenschr 117:106-108, 2005 https://doi.org/10.1007/s00508-004-0291-x
  15. Prince LA, Stork CM. Prolonged cardiotoxicity from poison lilly (Veratrum viride). Vet Hum Toxicol 42:282-285, 2000
  16. Crummett D, Bronstein D, Weaver Z 3rd. Accidental Veratrum viride poisoning in three 'ramp' foragers. N C Med J 46:469-471, 1985
  17. Browne CA, Sim FR, Rae ID, Keeler RF. Isolation of teratogenic alkaloids by reversed-phase high-performance liquid chromatography. J Chromatogr 336:211-220, 1984 https://doi.org/10.1016/S0378-4347(00)85143-9
  18. Magnani B, Woolf AD. Cardiotoxic plants. In: Brent J, Wallace KL, Burkhart KK, Phillips SD, Donovan W, eds. Critical care toxicology: diagnosis and management of the critically poisoned patient. p. 1325-1334, Philadelphia, Elsevier Mosby, 2005