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1.
Clin Toxicol (Phila) ; 56(9): 841-845, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29490507

RESUMO

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.


Assuntos
Antieméticos/uso terapêutico , Gastroenteropatias/tratamento farmacológico , Intoxicação por Plantas/tratamento farmacológico , Intoxicação por Plantas/fisiopatologia , Alcaloides de Veratrum/envenenamento , Veratrum/envenenamento , Vômito/tratamento farmacológico , Adulto , Feminino , Gastroenteropatias/etiologia , Georgia , Humanos , Masculino , Resultado do Tratamento , Vômito/etiologia
2.
Anaesthesist ; 64(5): 381-4, 2015 May.
Artigo em Alemão | MEDLINE | ID: mdl-25812545

RESUMO

This article reports the case of a 62-year-old male patient who ingested the roots of Monkshood (Aconitum napellus) and white hellebore (Veratrum album) dissolved in alcohol with a suicidal intention and suffered cardiotoxic and neurotoxic symptoms. After contacting the Poison Information Centre ventricular arrhythmia was treated with high-dose magnesium sulphate as the only antiarrhythmic agent and subsequently a stable sinus rhythm could be established after approximately 3 h. Aconitum napellus is considered the most poisonous plant in Europe and it is found in gardens, the Alps and the Highlands. Poisoning is mainly caused by the alkaloid aconite that leads to persistent opening and activation of voltage-dependent sodium channels resulting in severe cardiac and neurological toxicity. As no specific antidote is known so far, poisoning is associated with a high mortality. The therapy with high-dose magnesium sulphate is based on in vitro and animal experiments as well as limited clinical case reports.


Assuntos
Aconitum/envenenamento , Antiarrítmicos/uso terapêutico , Sulfato de Magnésio/uso terapêutico , Veratrum/envenenamento , Alcaloides/envenenamento , Antiarrítmicos/administração & dosagem , Arritmias Cardíacas/induzido quimicamente , Arritmias Cardíacas/tratamento farmacológico , Eletrocardiografia , Cardiopatias/induzido quimicamente , Cardiopatias/tratamento farmacológico , Humanos , Sulfato de Magnésio/administração & dosagem , Masculino , Pessoa de Meia-Idade , Síndromes Neurotóxicas/tratamento farmacológico , Agonistas de Canais de Sódio/envenenamento , Canais de Sódio/efeitos dos fármacos , Tentativa de Suicídio , Taquicardia/induzido quimicamente , Taquicardia/tratamento farmacológico
5.
Shokuhin Eiseigaku Zasshi ; 55(1): 55-63, 2014.
Artigo em Japonês | MEDLINE | ID: mdl-24598227

RESUMO

In the present study, we reviewed food poisoning data published by the Ministry of Health, Labour and Welfare of Japan from 1961 to 2010 in Japan to analyze the trends of plant toxin food poisonings (PTFPs). The annual number of incidents of PTFPs has gradually increased since 1995. PTFPs were predominantly caused by Datura spp., Veratrum spp. and Aconitum spp. Although PTFPs frequently occurred in April and May, poisonings caused by some plants occurred in all seasons, e.g. Datura spp. The major location of PTFPs was "at home", and most of the patients had accidentally harvested poisonous plants. During the past decade, the numbers of incidents of PTFPs caused by Veratrum spp., Narcissus spp., Solanum tuberosum and Alocasia odora were especially increased. Consumer advice to prevent PTFPs associated with certain plants that are cultivated in gardens and contain toxic substances is needed, because PTFPs caused by such plants are increasing. In addition, education of elementary school teachers and children about the potential risks of natural toxins in plants, particularly Solanum tuberosum, is desirable.


Assuntos
Intoxicação por Plantas/epidemiologia , Aconitum/envenenamento , Alocasia/envenenamento , Datura/envenenamento , Humanos , Japão/epidemiologia , Narcissus/envenenamento , Intoxicação por Plantas/mortalidade , Estações do Ano , Solanum tuberosum/envenenamento , Fatores de Tempo , Veratrum/envenenamento
6.
Clin Toxicol (Phila) ; 52(1): 72-7, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24369045

RESUMO

OBJECTIVE: To investigate the death of Alexander the Great to determine if he died from natural causes or was poisoned and, if the latter, what was the most likely poison. METHODS: OVID MEDLINE (January 1950-May 2013) and ISI Web of Science (1900-May 2013) databases were searched and bibliographies of identified articles were screened for additional relevant studies. These searches identified 53 relevant citations. Classical literature associated with Alexander's death. There are two divergent accounts of Alexander's death. The first has its origins in the Royal Diary, allegedly kept in Alexander's court. The second account survives in various versions of the Alexander Romance. Nature of the terminal illness. The Royal Diary describes a gradual onset of fever, with a progressive inability to walk, leading to Alexander's death, without offering a cause of his demise. In contrast, the Romance implies that members of Alexander's inner circle conspired to poison him. The various medical hypotheses include cumulative debilitation from his previous wounds, the complications of alcohol imbibing (resulting in alcohol hepatitis, acute pancreatitis, or perforated peptic ulcer), grief, a congenital abnormality, and an unhealthy environment in Babylon possibly exacerbated by malaria, typhoid fever, or some other parasitic or viral illness. Was it poisoning? Of all the chemical and botanical poisons reviewed, we believe the alkaloids present in the various Veratrum species, notably Veratrum album, were capable of killing Alexander with comparable symptoms to those Alexander reportedly experienced over the 12 days of his illness. Veratrum poisoning is heralded by the sudden onset of epigastric and substernal pain, which may also be accompanied by nausea and vomiting, followed by bradycardia and hypotension with severe muscular weakness. Alexander suffered similar features for the duration of his illness. CONCLUSION: If Alexander the Great was poisoned, Veratrum album offers a more plausible cause than arsenic, strychnine, and other botanical poisons.


Assuntos
Envenenamento/história , Alcaloides de Veratrum/história , Alcaloides de Veratrum/envenenamento , Veratrum/envenenamento , Adulto , Bradicardia/induzido quimicamente , Causas de Morte , Pessoas Famosas , Febre/induzido quimicamente , História Antiga , Humanos , Hipotensão/induzido quimicamente , Masculino , Debilidade Muscular/induzido quimicamente , Dor/induzido quimicamente
8.
Clin Toxicol (Phila) ; 48(9): 949-52, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21171854

RESUMO

INTRODUCTION: Veratrum album (white or false hellebore) is a poisonous plant containing steroidal alkaloids that cause nausea, vomiting, headache, visual disturbances, paresthesia, dizziness, bradycardia, atrioventricular block, hypotension, and syncope. It is regularly mistaken for Gentiana lutea (yellow gentian). We report accidental poisoning with V. album mistaken for Allium ursinum (wild garlic), a wild plant used in soups and salads in Central Europe. CASE SERIES: Four adults (24-45 years) accidentally ingested V. album mistaken for A. ursinum in self-prepared salads and soups. Within 15-30 min of ingestion they developed nausea, vomiting, and abdominal pain. At the same time dizziness, tingling, dimmed and jumping vision, transient blindness, and confusion appeared. On arrival at the ED, all patients had sinus bradycardia and hypotension. Following treatment the patients were discharged well 24-48 h after ingestion. CONCLUSION: In patients presenting with gastrointestinal, neurological, and cardiovascular symptoms a history of wild plant ingestion suggests possible poisoning with V. album mistaken for wild garlic.


Assuntos
Allium/envenenamento , Intoxicação por Plantas/diagnóstico , Veratrum/envenenamento , Acidentes , Adulto , Erros de Diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
9.
Clin Toxicol (Phila) ; 48(3): 234-7, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20170391

RESUMO

INTRODUCTION: White or false hellebore (Veratrum album) has a toxicological relevance because of the potential for misidentification of this plant as yellow gentian (Gentiana lutea). CASE SERIES: We report a retrospective case series of 11 children (8-12 years) with accidental intake of V. album at a youth camp where they had collected herbs for preparing fresh herb tea. Two children (18%) remained asymptomatic. Nine (82%) developed mild gastrointestinal symptoms, six (55%) presented neurological symptoms, and three (27%) showed bradycardia. All children recovered completely within 10 h of ingestion. The plant was identified at the emergency department; however, detection of veratridine and cevadine by means of high-performance liquid chromatography-Mass spectrometry from the blood of the child with the most severe symptoms was negative (limit 0.01 ng/mL). DISCUSSION: Veratrum species contain more than 200 different alkaloids, which are the principal toxins and are responsible for most clinical symptoms. There are likely multiple mechanisms of toxicity and some of them are only partially understood. The opening of voltage-gated sodium channels is probably one of the most relevant pathophysiological mechanisms. CONCLUSIONS: Veratrum album intoxication in children demonstrated the same clinical course as observed in adults. Accidental ingestion of a low dose of the plant had a favorable outcome with supportive care.


Assuntos
Intoxicação por Plantas/etiologia , Alcaloides de Veratrum/envenenamento , Veratrum/envenenamento , Bradicardia/etiologia , Criança , Gastroenteropatias/etiologia , Humanos , Doenças do Sistema Nervoso/etiologia , Estudos Retrospectivos , Canais de Sódio/efeitos dos fármacos , Canais de Sódio/metabolismo , Chá/química , Veratrum/química
10.
J Anal Toxicol ; 32(9): 768-73, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-19021933

RESUMO

A 49-year-old man consumed two glasses (approximately 2 x 20 mL) of a beverage containing yellow gentian (Gentiana lutea). Shortly after ingestion, he developed nausea, vomiting, and oral paraesthesia. On admission to the hospital he suffered from severe bradycardia (35 beats/min) and hypotension (50/30 mm Hg), and he was treated with activated charcoal, antiemetics (metoclopramide, ondansetron), atropine, and intravenous electrolytic solution. The initial suspicion of Veratrum poisoning could be confirmed by identifying protoveratrines A (ProA) and protoveratrine B (ProB) in a sample from the beverage as well as in the patients serum by liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS-MS). The yellow-colored beverage contained 25% ethanol (by headspace gas chromatography), 20.4 mg/L ProA, and 13.7 mg/L ProB. The serum concentration of ProA was 1162 ng/L and ProB was 402 ng/L. Veratridine, cevadine, and jervine were not detected, neither in the beverage nor in the serum sample. The lower limits of quantitation for all compounds is 10 microg/L (S/N > 10, beverage) and 100 ng/L (S/N > 10, serum). After treatment, the patient completely recovered from the symptoms within 24 h and was discharged from the hospital. The analytical method described was developed for the simultaneous identification and quantitation of five Veratrum alkaloids. The method is based on a liquid-liquid extraction followed by LC-MS-MS analysis. The time needed for analysis was 6 min.


Assuntos
Alcaloides de Veratrum/análise , Alcaloides de Veratrum/envenenamento , Veratrum/química , Veratrum/envenenamento , Acidentes , Bebidas Alcoólicas/análise , Bebidas Alcoólicas/envenenamento , Antídotos/uso terapêutico , Antieméticos/uso terapêutico , Carvão Vegetal/uso terapêutico , Cromatografia Líquida de Alta Pressão , Cromatografia em Camada Delgada , Gentiana , Hemodinâmica/efeitos dos fármacos , Humanos , Indicadores e Reagentes , Masculino , Espectrometria de Massas , Pessoa de Meia-Idade , Espectrometria de Massas por Ionização por Electrospray , Espectrofotometria Ultravioleta
11.
Wien Klin Wochenschr ; 117(3): 106-8, 2005 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15773425

RESUMO

Veratrum album is a poisonous plant that can easily be mistaken for the yellow gentian, Gentiana lutea, used in beverages. Two adult men were brought to the emergency department six hours after drinking gentian spirit. Each presented with nausea and vomiting, preceded by headache, developed within one hour after ingestion, and followed by diarrhea in one of the patients. Vital signs were normal except for heart rates of 42 and 45 beats per minute in the two patients, respectively. Laboratory findings were unremarkable. Electrocardiograms revealed sinus bradycardia. Activated charcoal and antiemetics were given and the patients were admitted for observation of signs of toxicity. The further clinical course was uneventful. Heart rates returned to normal within eight hours after admission. Retrospective investigation of the gentian beverage confirmed that V. album was mistaken for G. lutea. Patients with clinical toxicity following unintentional ingestion of V. album should be kept under observation and generally recover with supportive care.


Assuntos
Bebidas Alcoólicas/toxicidade , Doenças Transmitidas por Alimentos/diagnóstico , Cefaleia/induzido quimicamente , Náusea/induzido quimicamente , Intoxicação por Plantas/diagnóstico , Veratrum/envenenamento , Vômito/induzido quimicamente , Idoso , Doenças Transmitidas por Alimentos/complicações , Cefaleia/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Náusea/diagnóstico , Intoxicação por Plantas/complicações , Vômito/diagnóstico
12.
Emerg Med Clin North Am ; 22(2): 299-313, vii, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15163569
13.
J Anal Toxicol ; 25(6): 481-5, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11550825

RESUMO

We report two fatal poisonings due to the ingestion of plant material. The two deceased were discovered in the water of a mountain lake about one month after the postmortem immersion of the corpses. Macroscopic examination of the stomachs revealed the presence of a very large number of small blackish granules, which were later identified as seeds of a Veratrum species. Veratridine and cevadine were identified and quantitated by high-performance liquid chromatography-electrospray ionization-mass spectrometry. Measured blood concentrations were 0.17 and 0.40 ng/mL for veratridine and 0.32 and 0.48 ng/mL for cevadine. The absence of other toxic substance led to the assumption that this massive ingestion was the cause of death, although the circumstances surrounding intake remained unknown.


Assuntos
Veratridina/sangue , Veratrina/sangue , Veratrum/envenenamento , Adulto , Cromatografia Líquida , Evolução Fatal , Medicina Legal , Humanos , Masculino , Espectrometria de Massas , Envenenamento/diagnóstico
14.
Homeopathie ; 4(3): 43-52, mai-juin 1987.
Artigo em Francês | HomeoIndex - Homeopatia | ID: hom-3159

RESUMO

VERATRUM ALBUM(le veratre blanc) est une liliacee, dont la tige, les feuilles et le rhizome renferment des alcaloides tres toxiques resistant a la dessication (foin). L'intoxication grave evolue vers la mort en quelques heures. Elle comporte des symptomes cardiovasculaires, nerveux, digestifs, respiratoires et urinaires. Le traitemente de l'animal intoxique est symptomatique. La comparaison de l'intoxication chez l'animal avec la Matiere Medicale de Lathoud montre que les modalites des symptomes digestifs et cardiovasculaires sont fidelement retrouves alors qu'aucun symptome pulmonaire, ni urinaire n'est decrit dans cette Matiere Medicale. HYPERICUM PERFORATUM(le millepertuis officinal) est une plante dont l'ingestion entraine au bout de quelques heures une photosensibilisation pruriante, voisine du fagopyrisme (sarrain). On observe des symptomes de photodermite sur les zones depigmentees ou a peau fine (prurit, oedeme, sensibilite a l'eau froide et au toucher) et parfois, des symptomes de keratite et de conjonctivite. Le traitement consiste principalement ennune mise a l'ombre de l'animal. La comparaison de cette intoxication chez l'animal avec la Matiere Medicale de Lathoud montre qu'aucun symptome semblable n'est decrit chez l'homme, si ce n'est peut-etre l'extreme sensibilite au toucher. MOLYBDENE. La carence en cuivre des vegetaux et du sol augmente la toxicite de Molybdene qui devient dangereux dans les fourages a teneus normale principalement pour les jeunes bovins (2 a 6 mois). Les signes digestifs (diarrhee acqueuse persistante), osseux, cutanes et generaux disparaissent quand on augmente les teneurs en cuivre de la ration. La pathogenesie du Molybdene n'est exposee que dans la Matiere Medicale de Julian ou nous ne retrouvons aucun des symptomes decrits chez l'animal intoxique


Assuntos
Animais , Hypericum/envenenamento , Veratrum/envenenamento , Molibdênio/envenenamento , Sintomas Toxicológicos/veterinária
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