Hikers poisoned: Veratrum steroidal alkaloid toxicity following ingestion of foraged Veratrum parviflorum.
Clin Toxicol (Phila)
; 56(9): 841-845, 2018 09.
Article
em En
| MEDLINE
| ID: mdl-29490507
ABSTRACT
INTRODUCTION:
Steroidal alkaloids are found in plants of the genus Veratrum. Their toxicity manifests as gastrointestinal symptoms followed by a Bezold-Jarisch reflex hypopnea, hypotension, and bradycardia. Some Veratrum steroidal alkaloids are also teratogens interfering with the hedgehog-2 signaling pathway, which causes cyclopsia and holoprosencephaly. We present a case of accidental poisoning from Veratrum parviflorum mistaken for the edible Allium tricoccum (ramps, wild leek). CASE HISTORY A 27-year-old man and his 25-year-old wife presented to the emergency department with nausea, vomiting, hypotension, and bradycardia after foraging and ingesting plants that they believed to be a local native species of wild leek.METHODS:
We collected and analyzed the implicated fresh plant material and both patients' serum/plasma. We used liquid chromatography-mass spectroscopy and high-resolution electrospray ionization time of flight tandem mass spectrometry to extract and characterize steroidal alkaloids from the foraged plant and patients' serum.RESULTS:
Our V. parviflorum samples contained verazine, veratramine, veratridine, and cyclopamine.DISCUSSION:
Steroidal alkaloids have been previously isolated from Veratrum viride and Veratrum album and toxicity has been reported mainly from V. album species.CONCLUSION:
V. parviflorum toxicity manifests with gastrointestinal and cardiac symptoms. Treatment is symptomatic and supportive as with previous case reports of toxicity with other Veratrum species.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Intoxicação por Plantas
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Veratrum
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Alcaloides de Veratrum
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Vômito
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Gastroenteropatias
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Antieméticos
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article