A fatal case of oleandrin poisoning

Wasfi, I.A.; Zorob, O.; Katheeri, Nawal A. Al; Awadhi, Anwar M. Al

doi:10.1016/j.forsciint.2008.05.002

Cited by 46 publications

(32 citation statements)

References 12 publications

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“…Most often, exposure was accidental and thus, since it can be supposed that only small quantities of plant material were ingested, outcomes were mostly asymptomatic or mild, and the patients experienced a full recovery even in cases with moderate or severe symptoms (with one exception of permanent visual impairment after ocular contact with highly irritating Euphorbia plant sap). However, since small doses of highly toxic plants can suffice for severe symptoms (Wasfi et al 2008), severe and fatal poisonings could also be observed in the accidental setting, as confirmed by the three fatal poisonings after accidental ingestion of Colchicum autumnale. Our observations are compatible with those reported in the literature (Jaspersen -Schib et 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 Overall, most enquiries concerned children.…”

Section: Discussionmentioning

confidence: 80%

Acute plant poisoning: Analysis of clinical features and circumstances of exposure

Fuchs¹,

Rauber-Lüthy²,

Kupferschmidt³

et al. 2011

Clinical Toxicology

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INTRODUCTION: Human contact with potentially toxic plants, which may occur through abuse or by accident or attempted suicide, is frequent and sometimes results in clinically significant toxicity. OBJECTIVE: The aim of the present study was to identify which plants may lead to severe poisoning, and to define the clinical relevance of plant toxicity for humans in Switzerland. METHODS: We analyzed 42,193 cases of human plant exposure and 255 acute moderate, severe, and lethal poisonings, which were reported to the Swiss Toxicological Information Centre between January 1995 and December 2009. RE-SULTS: Plant contact was rarely responsible for serious poisonings. Lethal intoxications were extremely rare and were caused by plants with cardiotoxic (Taxus baccata) or mitosis-inhibiting (Colchicum autumnale) properties. CONCLUSIONS: Most often, plant contact was accidental and patients remained asymptomatic or developed mild symptoms, which fully resolved within a short time. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 properties. Most often, plant contact was accidental and patients remained asymptomatic or developed mild symptoms, which fully resolved within a short time.

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Section: Discussionmentioning

confidence: 80%

Acute plant poisoning: Analysis of clinical features and circumstances of exposure

Fuchs¹,

Rauber-Lüthy²,

Kupferschmidt³

et al. 2011

Clinical Toxicology

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“…Previous studies have highlighted the conduction abnormalities associated with oleander poisoning 8 . Dysrhythmias characterized by increased automaticity and conduction blockade, when combined, are highly suggestive of glycoside etiology 11 . These include dysrhythmia, sinus bradycardia with all types of AV nodal block, junctional rhythms and sinus arrest 9,12 .…”

Section: Figure 2 Factors Involved In Oleander Toxicitymentioning

confidence: 99%

Oleander toxicity – the clinical spectrum and mortality predictors: an observational study

Gopalakrishnan¹,

Kandasamy²,

Isaac³

et al. 2017

Internet Journal of Medical Update - EJOURNAL

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ABSTRACT:A major cause of mortality in Government Villupuram Medical College & Hospital is due to toxin exposure. Oleander poisoning ranks second in the list being superseded only by organophosphate poisoning. Data on the incidence, clinical features and the determinants of mortality are scanty. Standardized treatment or monitoring protocols are lacking. The study aimed to identify key mortality predictors in oleander poisoning, document the clinical spectrum of patients presenting with oleander poisoningand to devise a standard assessment protocol in oleander-poisoned patients. This is a prospective, observational study conducted at Villupuram Medical College. Consecutive hospitalized patients who had consumed oleander seeds, fruits or leaves were included in the study after obtaining informed, written consent. Upon registration, detailed history, clinical examination, baseline investigations and targeted investigations were performed. The data were documented in the standardized case proforma and subsequently computed. Patients were followed up 12 hourly by clinical examination and ECG recordings for a duration of 3 days. The data were analyzed using standard statistical methods. A total of 101 patients (46 male and 55 female) were enrolled into the study. There were 18 deaths, most of them (82.55%) occurring within 24 hours of intake. Among the parameters assessed, females, low BMI (Body Mass Index), consumption of > 3 seeds, delayed presentation (after 120 minutes), altered mental status, clinical shock, presence of heart block and absent p waves in ECG were significantly associated with mortality. Males, high BMI, low dosage of poison (<=3 seeds) and hemodynamic stability on day 1 were associated with favorable outcomes. ST-T segment changes, sinus tachycardia, ventricular premature contractions and administration of orciprenaline had no significant effect on the outcome. Oleander poisoning claims lives in the rural tropics. Institutional assessment and treatment protocols based on the infrastructure and expertise available are the need of the hour. Prompt first aid, critical assessment and timely referral for cardiac pacing can cut down mortality to a large extent.

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“…Decoction of leaves has been applied externally in the treatment of scabies and to reduce swellings [10] . The root is a powerful resolvent (power to disperse inflammatory).…”

Section: Patel Et Almentioning

confidence: 99%

Physical Evaluation and Qualitative Chemical Examination of Flowers Extract of Nerium Indicum.

Govind¹

2011

Int Jour of Biomed Res

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Nerium indicum is evergreen plant belonging to the Apocynaceae Family. The plant species collected in state of Madhya Pradesh, India. The flowers of Nerium indicum were collected locally, shade dried and extracted with petroleum ether and methanol by using Soxhlet apparatus. The preliminary phytochemical screening was carried out for the presence of alkaloids, flavonoids, carbohydrate glycosides, tannins, terpeniods, phenol and absence of steroids and saponins for methanolic extracts of Nerium indicum (flowers). The physical evaluation was carried out for the determination of methanol-soluble extractive value, watersoluble extractive value, Hexane-soluble extractive value; ash value includes total ash, acid insoluble ash and water-soluble ash, and moisture content for flowers of Nerium indicum.

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A fatal case of oleandrin poisoning

Cited by 46 publications

References 12 publications

Acute plant poisoning: Analysis of clinical features and circumstances of exposure

Acute plant poisoning: Analysis of clinical features and circumstances of exposure

Oleander toxicity – the clinical spectrum and mortality predictors: an observational study

Physical Evaluation and Qualitative Chemical Examination of Flowers Extract of Nerium Indicum.

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