Document Detail


An outbreak of foxglove leaf poisoning.
MedLine Citation:
PMID:  20171590     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Comfrey (Symphytum officinale) leaves resemble those of foxglove (Digitalis purpurea) when the plant is not in bloom and, therefore, cardiac glycoside poisoning may occur when people confuse foxglove with comfrey. We report an outbreak of foxglove leaf poisoning following the use of alleged "comfrey" herbal tea. Nine patients were involved and initially presented with nausea, vomiting, diarrhea and dizziness. Significant cardiotoxicity developed later among the 3 patients who also had mild hyperkalemia. Peak serum digoxin concentration measured by immunoassay was elevated in all patients and ranged from 4.4 ng/mL to 139.5 ng/mL. Patients with severe cardiotoxicity were treated with temporary cardiac pacing. Moreover, 40-80 mg of digoxin-specific antibody therapy was given without any effect. All patients recovered uneventfully. Our report highlights the potential risk of misidentification of herbs; in this case, D. purpurea was mistaken for S. officinale. Physicians should be aware that cardiac glycoside poisoning could arise from such misidentification. Public education about the toxicity of D. purpurea poisoning may reduce the risk of misidentification and subsequent poisoning.
Authors:
Chun-Chi Lin; Chen-Chang Yang; Dong-Haur Phua; Jou-Fang Deng; Li-Hua Lu
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of the Chinese Medical Association : JCMA     Volume:  73     ISSN:  1728-7731     ISO Abbreviation:  J Chin Med Assoc     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-22     Completed Date:  2010-05-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101174817     Medline TA:  J Chin Med Assoc     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  97-100     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier. Published by Elsevier B.V. All rights reserved.
Affiliation:
Department of Medicine, National Yang-Ming University Hospital, I-Lan, Taipei, Taiwan, ROC.
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MeSH Terms
Descriptor/Qualifier:
Antibodies / therapeutic use
Digitalis / poisoning*
Digoxin / immunology
Disease Outbreaks*
Female
Humans
Middle Aged
Plant Poisoning / epidemiology*,  therapy
Potassium / blood
Chemical
Reg. No./Substance:
0/Antibodies; 20830-75-5/Digoxin; 7440-09-7/Potassium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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