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Hikers poisoned: Veratrum steroidal alkaloid toxicity following ingestion of foraged Veratrum parviflorum.
Clin Toxicol (Phila) ; 56(9): 841-845, 2018 09.
Artigo em Inglês | 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.
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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Intoxicação por Plantas / Veratrum / Alcaloides de Veratrum / Vômito / Gastroenteropatias / Antieméticos Tipo de estudo: Relato de casos Aspecto clínico: Terapia Limite: Adulto / Feminino / Humanos / Masculino País/Região como assunto: América do Norte Idioma: Inglês Revista: Clin Toxicol (Phila) Assunto da revista: Toxicologia Ano de publicação: 2018 Tipo de documento: Artigo País de afiliação: Estados Unidos