Successful Rescue of a Patient with Acute Aconitine Poisoning Complicated by Polycystic Renal Hemorrhage

Abstract

Introduction: Aconitine is a highly toxic diterpenoid alkaloid, produced by plants of the Aconitum genus, that is still used in Chinese herbal medicines. Aconitine poisoning remains common in China and other parts of Asia.Case Report: A 48-year-old man received a diagnosis of aconitine poisoning after ingesting herbal medicinal wine made with caowu, which is made from Aconitum kusnezoffii roots, and was admitted to our hospital's emergency department. Electrocardiography and thoracoabdominal computed tomography showed cardiovascular toxicity from aconitine poisoning along with polycystic renal hemorrhaging. Because the arrhythmia was not controlled with lidocaine, blood purification with a reduced dosage of heparin was performed to treat the arrhythmia and to avoid increasing the bleeding of the polycystic renal hemorrhage. The patient recovered from aconitine poisoning and polycystic kidney hemorrhage. Conclusions:This case significantly advances our understanding of hemoperfusion with reduced heparin for the treatment of ventricular arrhythmia caused by aconitine poisoning. (J Nippon Med Sch 2015; 82: 257 261)

Neurotoxicity mechanism of aconitine in HT22 cells studied by microfluidic chip-mass spectrometry

“…Thus, it is of great concern to researchers exploring the toxic mechanism and attenuated methods of aconitine. The typical clinical features of aconitine neurotoxicity involve CNS diseases such as involuntary tremors and paroxysmal convulsion [ 30 , 31 ]. However, the neurotoxic mechanisms of aconitine remain poorly understood.…”

The toxicology and detoxification of Aconitum: traditional and modern views

“…Another worth mentioning case study was a Caowu poisoning that happened on a 48-year-old Chinese man [ 112 ]. He consumed some herbal medicinal wine before admitting to the hospital accident and emergency department.…”

Refractory Ventricular Arrhythmia Induced by Aconite Intoxication and Its Treatment with Extracorporeal Cardiopulmonary Resuscitation

“…Aconite induces refractory ventricular arrhythmia. The symptoms of poisoning appear 10 minutes to 3 hours after aconite is ingested [3,4]. When cardiogenic shock are refractory to medical treatment, it is most important to maintain blood pressure and tissue oxygenation by the use of a percutaneous cardiopulmonary bypass [5].…”