RESUMEN
Cerbera odollam or "pong-pong" tree contains cardiac glycosides similar to digoxin, oleander and yellow oleander. Cerbera odollam is a common method of suicide in South East Asia and has also been used as a weight loss supplement. We present a case of a 33-year-old female presenting with lethargy, vomiting, bradycardia, severe hyperkalemia of 8.9 mEq/L, slow atrial fibrillation followed by cardiovascular collapse following the ingestion of "pong-pong", the kernel of Cerbera odollam, as a weight loss supplement. Despite the administration of a total of nine vials of digoxin-specific Fab the patient could not be resuscitated. Clinicians should be aware of natural cardiac glycosides being uses as weight-loss agents and consider acute cardiac glycoside poisoning in patients with hyperkalemia, abnormal cardiovascular signs, symptoms and abnormal ECG findings.
Asunto(s)
Fármacos Antiobesidad/toxicidad , Apocynaceae/toxicidad , Glicósidos Cardíacos/toxicidad , Suplementos Dietéticos/toxicidad , Adulto , Fármacos Antiobesidad/provisión & distribución , Glicósidos Cardíacos/provisión & distribución , Suplementos Dietéticos/provisión & distribución , Resultado Fatal , Femenino , Humanos , InternetRESUMEN
The evaluation of abdominal pain can be considerably more challenging in elderly patients. A higher likelihood of life-threatening pathology combined with a myriad of diagnostic pitfalls in this population mandate a more cautious approach with greater use of diagnostic resources and specialist consultation.
