RESUMEN
No abstract available.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Angiografía Coronaria , Electrocardiografía , Flores , Miel/envenenamiento , Infarto de la Pared Inferior del Miocardio/inducido químicamente , Néctar de las Plantas , Valor Predictivo de las Pruebas , Rhododendron , Factores de Riesgo , Toxinas Biológicas/envenenamientoRESUMEN
Cleistanthus collinus is an extremely toxic plant poison. Cleistanthin A and B, the toxins of Cleistanthus collinus, are diphyllin glycosides which produce cardiac arrhythmias, urinary potassium wasting, hypoxia, metabolic acidosis and hypotension. We report ARDS, distal renal tubular acidosis and distributive shock secondary to inappropriate vasodilatation in a case following ingestion of its leaves.
Asunto(s)
Acetilcisteína/administración & dosificación , Acidosis Tubular Renal/etiología , Adulto , Glicósidos/envenenamiento , Humanos , Hipopotasemia/etiología , Lignanos/envenenamiento , Masculino , Hojas de la Planta/envenenamiento , Intoxicación por Plantas , Plantas Tóxicas , Síndrome de Dificultad Respiratoria/etiología , Choque/etiología , Toxinas Biológicas/envenenamiento , Resultado del Tratamiento , VasodilataciónRESUMEN
AIMS: 1. To study the clinical features in patients with Cleistanthus collinus poisoning, 2.To study in them the effect of Cleistanthus collinus poisoning on the various organ systems and metabolic parameters using standard laboratory investigations. METHODS: All patients admitted to the hospital between September 1998 and April 2000 were studied. Statistical analysis of the results was done using chi-square test, Fisher's exact test and Student's 't' test. RESULTS: Forty six cases were studied, 15 (32%) of whom died. Eighty percent of the patients were in the second to third decade. The female:male ratio was 3:2. Ingestion of the poison as a decoction prepared from the leaves and ingestion of a large number of leaves otherwise were associated with a poor outcome. While survivors remained relatively asymptomatic, fatally poisoned patients presented with significant clinical signs and symptoms, however, laboratory abnormalities such as hypokalaemia, hyponatremia, an elevated AST/LDH/CPK/CPK-MB, nonspecific ST-T changes and QTc prolongation on ECG, metabolic acidosis and hypoxia with widened alveolar-arterial oxygen difference (A-aDO2) were seen in both groups. CONCLUSION: It is a poisoning seen in the young with significant mortality. Cause of death appears to be mainly due to its cardiac and respiratory effects. Metabolic disturbances especially hypokalaemia was a prominent feature. Most deaths occurred on the 3rd day and all within a week. No specific antidote is available.