Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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A Patient Presenting with Elevations of Cardiac Enzyme Levels after Veratrum Oxysepalum Ingestion

박새풀 섭취 후 발생한 심장효소 상승 1례

  • Hwang, Ji Young (Department of Emergency Medical Technology, Daejeon University) ;
  • Kim, Hyun (Department of Emergency Medicine, Wonju College of Medicine, Yonsei University)
  • 황지영 (대전대학교 응급구조학과) ;
  • 김현 (연세대학교 원주의과대학 응급의학교실)
  • Received : 2015.11.30
  • Accepted : 2015.12.18
  • Published : 2015.12.31
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Abstract

Veratrum patulum has toxicological relevance because of the potential for misidentification of this plant as mountain garlic. Veratrum patulum has an ester-alkaloid that provokes cardiac arrhythmias by excessive vagal stimulation and depression of the sinoatrial and atrioventricular nodes of the heart and hypotension, cardiomegaly. We report on a retrospective case of successful outcome in patients with veratrum patulum poisoning through active treatment from the early phase after ingestion. We report on a case involving a patient who experienced dizziness, dyspnea, hypotension, and elevation of cardiac enzyme, cardiomegaly. These cases were kept under observation and generally recovered with supportive care. We report on cases of veratrum patulum poisoning with review of literature.

Keywords

References

  1. Kang YH. Encyclopedia of Life Science. 1th ed. Seoul: Academicbook; 2008. p. 200-12.
  2. Schep LJ, Schmierer DM, Fountain JS. Veratrum poisoning. Toxicol Rev 2006;25:73?8. https://doi.org/10.2165/00139709-200625020-00001
  3. Jung YO, Park NB, Gwak JS, Jung SJ. Guide to wild flower - spring. Seoul:Pureun Gim Haengbok;2010. p.135-9.
  4. Zagler B, Zegler A, Salvatore C, Pechlaner C, de Giorgi F, Wiedermann CJ. Dietary poisoning with veratrum album: a report of two cases. Wien Kin Wochenschr 2005;117:106-8. https://doi.org/10.1007/s00508-004-0291-x
  5. Festa M, Andreetto B, Ballaris MA, Panio A, Piervittori R. A case of Veratrum poisoning. Minerva Anestesiol 1996;62:195-6.
  6. Quatrehomme G, Bertrand F, Chauvet C, Ollier A. Intoxication from Veratrum album. Hum Exp Toxicol 1993;12:111-5. https://doi.org/10.1177/096032719301200203
  7. James LF, Panter KE, Gaffield W, Molyneux RJ. Biomedical applications of poisonous plant research. J Agric Food Chem 2004;52:3211-30. https://doi.org/10.1021/jf0308206
  8. Fogh A, Kulling P, Wickstrom E. Veratrum alkaloids in sneezing-powder: a potential danger. J Toxicol Clin Toxicol 1983;20:175-9. https://doi.org/10.3109/15563658308990062
  9. Dunnigan D, Adelman RD, Beyda DH. A young child with altered mental status. Clin Pediatr (Phila). Jan-Feb 2002;41:43-5. https://doi.org/10.1177/000992280204100109
  10. Heilpern KL. Zigadenus poisoning. Ann Emerg Med Feb 1995;25:259-62. https://doi.org/10.1016/S0196-0644(95)70336-5
  11. Quatrehomme G, Bertrand F, Chauvet C, Ollier A. Intoxication from Veratrum album. Hum Exp Toxicol Mar 1993;12:111-5. https://doi.org/10.1177/096032719301200203
  12. Winer BM. A comparison between protoveratrine A and protoveratrine B orally in arterial hypertension; a therapeutically important difference in activity. N Engl J Med 1956;255:1173-9. https://doi.org/10.1056/NEJM195612202552502
  13. Wang SC, Ngai SH, Grossman RG. Mechanism of vasomotor action of Veratrum alkaloids: extravagal sites of action of veriloid, protoveratrine, germitrine, neogermitrine, germerine, veratridine and veratramine. J Pharmacol Exp Ther 1995;113:100-14.
  14. Trbovic SM, Radulovacki M, Carley DW. Protoveratrines A and B increase sleep apnea index in Sprague-Dawley rats. J Appl Physiol 1997;83:1602-6. https://doi.org/10.1152/jappl.1997.83.5.1602
  15. Gaze DC. Universal definition of acute myocardial infarction: The role of cardiac troponins and the need for sensitive and standardized assays. Curr Opin Investig Drugs 2008;9:245-6.
  16. Margolin EG, Levine HD, Merrill JP. Cardiac arrhythmias associated with protoveratrine. Am Heart J 1956;52:257-8. https://doi.org/10.1016/0002-8703(56)90263-0
  17. Silva Freitas EM, Fagian MM, Cruz H?fling MA. Effects of veratine and veratridine on oxygen consumption and electrical membrane potentials. Toxicon 2006;57:780-7.
  18. Rauber-Luthy C, Halbsguth U, Kupferschmidt H, Konig N, Megevand C, Zihlmann K, Ceschi A. Low-dose exposure to Veratrum album in children causes mild effects - a case series. Clin Toxicol 2010;48:234-7. https://doi.org/10.3109/15563650903575243
  19. Carlier P, Efthymiou ML, Garnier R, Hoffelt J, Fournier E. Poisoning with Veratrum-containing sneezing powders. Hum Toxicol 1983;2:321-5. https://doi.org/10.1177/096032718300200224
  20. Fogh A, Kulling P, Wickstrom E. Veratrum alkaloids in sneezing-powder a potential danger. J Toxicol Clin Toxicol 1983;20:175-9. https://doi.org/10.3109/15563658308990062
  21. Gaillard Y, Pepin G. LC-EI-MS determination of veratridine and cevadine in two fatal cases of Veratrum album poisoning. J Anal Toxicol 2001;25:481-5. https://doi.org/10.1093/jat/25.6.481
  22. Physician's Desk Reference. PDR for Herbal Medicines. 2nd ed. Montvale: Medical Economics; 2000. p.803.
  23. Schep LJ, Schmierer DM, Fountain JS. Veratrum poisoning. Toxicol Rev 2006;25:73-8. https://doi.org/10.2165/00139709-200625020-00001