Hiponatremia grave secundaria a la exposición a veneno de Phyllomedusa Bicolor (Rana Kambó): caso clínico / Severe hyponatremia secondary to Phyllomedusa bicolor (Kambó frog) poisoning: report of one case

Phyllomedusa bicolor or Kambo is a frog that lives in the Amazon rainforest. It can release through its skin a substance used in healing rituals that are common among South-American tribes, as well as in urban people of America and Europe. We report a 41-year-old female patient who, during a healing ritual consumed ayahuasca (a drink obtained from the mixture of Banisteriopsis caapi, Psychotria viridis and Mimosa hostilis) and 12 hours later received the poison of Kambo Frog (Phyllomedusa bicolor) on superficial right shoulder skin burns. The ritual included a minimum of six-liter water intake over a few hours period. She evolved with clouding of sensorium, motor agitation, frequent vomiting, and generalized tonic-clonic seizures. She presented lethargic to the emergency room, with a weak pupillary light reflex, generalized stiffness, moving all four limbs. Laboratory showed severe hyponatremia (120 mEq/L) and a creatine kinase level of 8,479 UI/L, that increased 107,216 IU/L within few days. An admission CT Brain scan was normal. The toxicological screening did not identify the presence of other substances. During hospitalization the patient developed severe psychomotor agitation controlled by a dexmedetomidine infusion, hyponatremia, low plasma osmolality (248 mOsm/kg), and disproportionately high urinary osmolality (448 mOsm/kg), suggestive of inappropriate antidiuretic hormone secretion syndrome (SIADH). With correction of hyponatremia, the patient gradually recovered consciousness. Rhabdomyolysis was assumed to be secondary to seizure and managed by volume and bicarbonate infusions with a positive response.

The effects of toadpoison and arsenic on the ultrastructure of dental pulp in dog / 实用口腔医学杂志

Objective:To observe the effects of toadpoison and arsenic on the ultrastructure of dental pulp,Methods :Dental pulp of 36 teeth in 3 dogs was exposed by operation and then direct dressing with toadpoison paste or arsenic paste was performed. 1,2,6 and 24 hours after operation ,the pulps were processed and examinedunder a trasmission electron microscope (JEM-2000EX). Results:In toadpoison treated group ,the deformityof the basernembrane of pulp nerve ,swelling of metochondrion,degeneration of nerve axite were observed 1 h after dressing,and were more obvious in 2, 6 and 24 h. Damage of capillary and pulp cells were alsoobserved.In arsenic treated group ,swelling and break of capillaries ,deformity and degeneration of mitochondrion and endoplasmic reticulum in endoepithelial cells were observed,and were more obvious following time lasting. Damages of pulp nerve and pulp cells were also observed. Conclusion:Toadpoison and arsenic are toxic to pulp tissues. But the angiotoxicity of arsenic is stronger than that of toadpoison,the neurotoxicity and protoplasmic toxicity of toadpoison are stronger than those of arsenic.