Poisoning by toxic plants in Hong Kong: a 15-year review.

INTRODUCTION: Hong Kong has a great diversity of plants, many of which are toxic to humans. The aim of this study was to identify the plant species most commonly involved in cases of plant poisoning in Hong Kong and to provide clinicians with a reference tool for the diagnosis and management of plant poisoning. METHODS: We retrospectively reviewed all plant poisoning cases referred to the Hospital Authority Toxicology Reference Laboratory from 1 January 2003 to 31 December 2017. Demographics, clinical presentation, laboratory findings, treatment and outcomes of patients, as well as morphological identification and analytical testing of the plant specimens, were investigated. RESULTS: A total of 62 cases involving 26 poisonous plant species were identified, among which Alocasia macrorrhizos (Giant Alocasia), Gelsemium elegans (Graceful Jessamine), and Rhododendron (Azalea) species were the three most commonly encountered. Gastrointestinal toxicity (n=30, 48%), neurological toxicity (n=22, 35%), and hepatotoxicity (n=6, 10%) were the three most common clinical problems. Forty-nine (79%) and eight (13%) patients had mild and moderate toxicity, respectively; they all recovered shortly with supportive treatment. The remaining five (8%) patients experienced severe toxicity requiring intensive care support. Most patients (n=61, 98%) used the plants intentionally: as a medicinal herb (n=31), as food (n=29), and for attempting suicide (n=1). Reasons for using the poisonous plants included misidentification (n=34, 55%), unawareness of the toxicity (n=20, 32%), and contamination (n=6, 10%). CONCLUSIONS: Although most plant exposure resulted in a self-limiting disease, severe poisonings were encountered. Epidemiology of plant poisonings is geographically specific. Clinicians should be aware of local poisonous plants and their toxicities.

Metabólitos bioativos e atividades biológicas, tóxicas e farmacológicas de plantas ornamentais: uma revisão das espécies hydrangea macrophylla, euphorbia milii, dieffenbachia seguine e dracaena trifasciata / Bioactive metabolites and biological, toxic and pharmacological activities of ornamental plants: a review of the species hydrangea macrophylla, euphorbia milii, dieffenbachia seguine and dracaena trifasciata / Metabolitos bioactivos y actividades biológicas, tóxicas y farmacológicas de plantas ornamentales: una revisión de las especies hydrangea macrophylla, euphorbia milii, dieffenbachia seguine y dracaena trifasciata

As plantas ornamentais foram selecionadas pelo homem a partir de caracteres atraentes e começaram a ser cultivadas por sua beleza. São utilizadas frequentemente em arquitetura e paisagismo de espaços externos, porém, pode possuir princípios ativos que as tornam tóxicas e que podem causar danos a saúde como irritações na pele e mucosas. No Brasil há descritas diversas plantas de uso ornamental e que são consideradas tóxicas, dentre elas podemos destacar popularmente hortênsia, comigo-ninguém-pode, espada-de- são-jorge e a coroa-de-cristo e na literatura o envenenamento humano por essas plantas tóxicas quase não é documentado o que despertou interesse nessa revisão. Logo, esse estudo possui objetivo de revisar as bases de dados em busca de informações de atividades biológicas, tóxicas, farmacológicas e de metabólitos bioativos das espécies Hydrangea macrophylla, Euphorbia milii, Dieffenbachia seguine e Dracaena trifasciata. Para o compilado de dados deste artigo de revisão, foram utilizados 51 artigos que reuniram as condições de elegibilidade buscadas. Os artigos foram lidos na integra e os dados agregados em tabela ou texto. Esta revisão observou que a maioria dos ensaios aplicados nessas espécies foram de caráter toxicológico e objetivavam a busca de veículos para controle de doenças ocasionadas por vetores. Os ensaios demonstraram potencial tóxico preliminar, justificando os efeitos relacionados à intoxicação ou aos danos á saúde como irritações na pele e mucosas.

Ornamental plants were selected by man from attractive characters and began to be cultivated for their beauty. They are often used in architecture and landscaping of outdoor spaces; however, they may have active ingredients that make them toxic and that can cause health damage such as skin and mucous membrane irritations. In Brazil there are described several plants of ornamental use and that are considered toxic, among them we can highlight hortênsia, comigo-ninguém-pode, espada-de-são-jorge e a coroa-de- cristo, and in the literature the human poisoning by these toxic plants is hardly documented which aroused interest in this review. Therefore, this study aims to review the databases in search of information on biological, toxic, pharmacological activities and bioactive metabolites of the species Hydrangea macrophylla, Euphorbia milii, Dieffenbachia seguine and Dracaena trifasciata. To compile data from this review article, 51 articles were used that met the sought eligibility conditions. The articles were read in full and the data aggregated in a table or text. This review noted that most of the tests applied to these species were toxicological in nature and aimed to search for vehicles to control diseases caused by vectors. The trials demonstrated preliminary toxic potential, justifying the effects related to intoxication or damage to health such as skin and mucous membrane irritations.

Las plantas ornamentales fueron seleccionadas por el hombre a partir de caracteres atractivos y empezaron a cultivarse por su belleza. A menudo se utilizan en la arquitectura y el paisajismo de espacios exteriores; sin embargo, pueden tener principios activos que las hacen tóxicas y que pueden causar daños a la salud, como irritaciones de la piel y de las mucosas. En Brasil están descritas varias plantas de uso ornamental y que son consideradas tóxicas, entre ellas se destacan hortênsia, comigo-ninguém-pode, espada-de-são-jorge e a coroa-de- cristo, y en la literatura el envenenamiento humano por estas plantas tóxicas está poco documentado lo que despertó el interés en esta revisión. Por lo tanto, este estudio tiene como objetivo revisar las bases de datos en busca de información sobre las actividades biológicas, tóxicas, farmacológicas y metabolitos bioactivos de las especies Hydrangea macrophylla, Euphorbia milii, Dieffenbachia seguine y Dracaena trifasciata. Para recopilar los datos de este artículo de revisión, se utilizaron 51 artículos que cumplían las condiciones de elegibilidad buscadas. Los artículos se leyeron en su totalidad y los datos se agregaron en una tabla o texto. En esta revisión se observó que la mayoría de los ensayos aplicados a estas especies eran de naturaleza toxicológica y tenían como objetivo la búsqueda de vehículos para el control de enfermedades causadas por vectores. Los ensayos demostraron potencial tóxico preliminar, justificando los efectos relacionados con intoxicación o daños a la salud, como irritaciones de piel y mucosas.

Atrioventricular block induced by mad-honey intoxication: confirmation of diagnosis by pollen analysis.

An unusual type of food poisoning, mad-honey intoxication, can be observed in the Black Sea region of Turkey and various other parts of the world. It can occur after ingestion of grayanotoxin-contaminated honey produced from the nectar of Rhododendron ponticum and other plant species, chiefly of the Ericaceae and Sapindaceae families. Mad-honey intoxication can result in severe cardiac complications, such as complete atrioventricular block. The diagnosis is generally reached on the basis of the patient's history of honey intake. In this report, we describe the case of a patient who had mad-honey-related complete atrioventricular block; in this instance, the diagnosis was confirmed by a pollen analysis of the suspect honey.