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Medicine Nov 2021Studies have previously reported misidentifying Caltha palustris (C. palustris) as Ligularia fischeri and its subsequent ingestion leading to abdominal pain and...
RATIONALE
Studies have previously reported misidentifying Caltha palustris (C. palustris) as Ligularia fischeri and its subsequent ingestion leading to abdominal pain and gastrointestinal symptoms, which are alleviated immediately. Bradycardia and hypotension may persist for several days, and an infusion of dopamine can restore a healthy state without complications. We report a case of C. palustris poisoning with protein-losing enteropathy that has not been reported previously. The patient died of multiple organ failure, and exhibited more severe clinical deterioration than previous cases due to prolonged shock.
PATIENT CONCERNS
A 70-year-old woman was admitted to the emergency department (ED) with complaints of epigastric pain, vomiting, and diarrhea after ingestion of a poisonous plant presumed to be C. palustris. The patient presented with bradycardia and hypotension after ED admission, and vasopressor infusion improved bradycardia but not hypotension, while the patient complained of severe epigastric pain.
DIAGNOSES
Abdominal computed tomography showed luminal distention and edematous thickening of the entire stomach lining, as well as small and large intestinal wall edema, indicating severe gastritis and enterocolitis. The laboratory test results suggested severe hypoalbuminemia, while the arterial blood gas analyses showed a continuous increase in metabolic acidosis.
INTERVENTIONS
As plant poisoning was suspected, activated charcoal was administered to the patient, followed by administration of vasopressors and other conservative therapies. Continuous renal replacement therapy (CRRT) was used for metabolic acidosis of increasing severity.
OUTCOMES
Despite the administration of vasopressors and other conservative therapies, the state of shock persisted, and metabolic acidosis did not improve even after CRRT. Ultimately, the patient died of multiple organ failure.
LESSONS
For many poisonous wild plants, the precise profile of toxic compounds and mechanisms of action remain to be identified; when there is insufficient literature reporting on suspected plant poisoning, the medical personnel providing the treatment should consider the various side effects that differ from the reported ones and the possibility of more severe clinical progress and poor prognosis.
Topics: Abdominal Pain; Acidosis; Aged; Bradycardia; Eating; Fatal Outcome; Female; Humans; Hypotension; Multiple Organ Failure; Nausea; Plant Poisoning; Vasoconstrictor Agents; Vomiting
PubMed: 34797336
DOI: 10.1097/MD.0000000000027891 -
Journal of Animal Science Jan 2020Fescue toxicosis is problematic for growing steers, causing lower DMI and productivity when fed endophyte-infected (E+) tall fescue. A complete understanding of...
Fescue toxicosis is problematic for growing steers, causing lower DMI and productivity when fed endophyte-infected (E+) tall fescue. A complete understanding of underlying mechanisms of how fescue toxicosis affects growing steers is lacking. Therefore, the overall objective of this multiexperiment study was to determine whether ruminally dosed ergovaline (ERV) affects rumen motility, rumen contents, and eating patterns. In Exp. 1, an 8-h period to assess ruminal motility began 4 h after feeding by monitoring pressure changes using a wireless system for 21 d. Eight ruminally cannulated steers (283 kg BW) were pair fed with alfalfa cubes (1.5 × NEm) and assigned to endophyte free (E-; 0 μg ERV/kg BW/d) or E+ treatment (20 μg ERV/kg BW/d). Overall, E+ steers had more frequent rumen contractions (Seed P = 0.05 and day of feeding P = 0.02). On days 7 to 9, both treatments showed lower frequencies and E- steers had greater amplitude of contractions (P < 0.001) that corresponded with decreased DMI. In Exp. 2, steers remained in pairs assigned in Exp. 1 (322 kg BW), but reversed seed treatments while increasing ERV levels (titrated 0, 5, 10, 15, and 20 μg ERV/kg BW/d over 57 d). There were no differences between E- and E+ for frequency (P = 0.137) or amplitude of contractions (P = 0.951), but increasing ERV dosage, decreased frequency (P = 0.018) and amplitude (P = 0.005), coinciding with lower DMI. In Exp. 3, 8 steers (589 kg) were pair fed and ruminally dosed 15 μg ERV/kg BW/d, and rumen motility data were collected for 21 d. E- steers showed higher amplitude and lower frequency of contractions than E+ steers with seed (P < 0.001), day (P < 0.001), and seed × day (P < 0.04) effects, but rumen fill was not different between E- and E+ (P > 0.29). Serum prolactin concentrations were lower in E+ steers in Exp. 1 to 3. Eating patterns of pair-fed E- and E+ steers were relatively slower in E+ than E- (Exp. 4) by measuring every 2 h across 24 h. Number of meals were higher in E+ than E- steers, but meal duration and meal size were not different between treatments. Rumen content (DM%) tended to be higher in E+ than in E- when steers were fed once a day (P = 0.07), but there was no difference for rumen content (DM%) when E- and E+ steers were fed 12 times a day (P = 0.13). These results suggest the changes in rumen fill associated with fescue toxicosis may be driven more by changes in feeding behavior and eating pattern rather than by changes in motility.
Topics: Animal Feed; Animals; Cattle; Digestion; Eating; Endophytes; Ergotamines; Feeding Behavior; Festuca; Male; Medicago sativa; Plant Poisoning; Prolactin; Random Allocation; Seeds
PubMed: 31850497
DOI: 10.1093/jas/skz374 -
Proceedings of the Royal Society of... Aug 1966
Review
Topics: Animals; Chick Embryo; Collagen; Female; Lathyrism; Pregnancy; Pregnancy, Animal; Rats
PubMed: 5331025
DOI: No ID Found -
PloS One 2023Reliable identification of plant species in the digestive tract of a deceased animal often represents the major key to diagnose a lethal intoxication with poisonous...
Reliable identification of plant species in the digestive tract of a deceased animal often represents the major key to diagnose a lethal intoxication with poisonous plants in veterinary pathology. In many cases, identification of the species is challenging or even impossible because the diagnostic morphological features have been degraded, and because the interpretation of such features requires a considerable expertise in plant anatomy and biodiversity. The use of DNA barcoding markers can support or even replace classical morphological assessment. While these markers have been widely used for plant taxonomy, their forensic application to clarify causes of animal poisoning is novel. In addition, we use specific single-nucleotide polymorphisms as fingerprints. This allows for a clear decision even in cases, where the conventionally used statistical e-values remain ambiguous. In the current work, we explore the feasibility of this strategy in a couple of exemplary cases, either in concert with anatomical diagnostics, or in cases where visual species identification is not possible, or where chemical toxin detection methods are not well established, complex, time consuming and expensive.
Topics: Animals; DNA Barcoding, Taxonomic; DNA; Plants, Toxic; Plant Poisoning; Forensic Medicine; Genetic Markers; DNA, Plant; Mammals
PubMed: 37967132
DOI: 10.1371/journal.pone.0292275 -
ESC Heart Failure Feb 2021This short communication aims to review the treatment of cardiogenic shock in patients with yew poisoning based on two case reports from our institution, focusing on the... (Review)
Review
AIMS
This short communication aims to review the treatment of cardiogenic shock in patients with yew poisoning based on two case reports from our institution, focusing on the use of extracorporeal life support (ECLS).
METHODS AND RESULTS
We report two cases of Taxus baccata poisoning treated with ECLS at our institution and review the literature based on a search in PubMed and Google Scholar on the topic of yew poisoning and ECLS. All cases were combined for analysis of demographics, ECLS therapy, and outcome. Case 1: A 35-year-old woman developed polymorphic ventricular tachycardia followed by cardiovascular arrest 5 h after orally ingesting a handful of yew needles. Successful resuscitation required ECLS for 72 h due to ongoing cardiac arrhythmias and cardiogenic shock. The patient left the hospital without neurological sequelae after 10 days. Case 2: A 30-year-old woman developed refractory cardiac arrhythmias and circulatory arrest. Resuscitation included ECLS for 71 h. T. baccata needles found by gastroscopy confirmed the diagnosis. The patient had no neurologic deficits and was transferred to psychiatry after 11 days.
REVIEW OF THE LITERATURE
Nine case reports were found and analysed along with our two cases. Five out of the 11 (45%) patients were female. Median (range) age was 28 (19-46) years. T. baccata needles were ingested with a suicidal intention in all patients. Median (range) duration of ECLS was 70 h (24-120 h). Eight (73%) patients had full neurological recovery.
CONCLUSIONS
Yew poisoning is a differential diagnosis in young psychiatric patients presenting with polymorphic ventricular tachycardia and cardiogenic shock. A characteristic cardiac contraction pattern in echocardiography may present a diagnostic clue. The early use of ECLS is a valuable bridge to recovery in most of these patients.
Topics: Adult; Arrhythmias, Cardiac; Extracorporeal Membrane Oxygenation; Female; Humans; Middle Aged; Plant Poisoning; Shock, Cardiogenic; Treatment Outcome
PubMed: 33232574
DOI: 10.1002/ehf2.12828 -
PloS One 2019Atypical myopathy (AM) in horses is caused by ingestion of seeds of the Acer species (Sapindaceae family). Methylenecyclopropylacetyl-CoA (MCPA-CoA), derived from...
Atypical myopathy (AM) in horses is caused by ingestion of seeds of the Acer species (Sapindaceae family). Methylenecyclopropylacetyl-CoA (MCPA-CoA), derived from hypoglycin A (HGA), is currently the only active toxin in Acer pseudoplatanus or Acer negundo seeds related to AM outbreaks. However, seeds or arils of various Sapindaceae (e.g., ackee, lychee, mamoncillo, longan fruit) also contain methylenecyclopropylglycine (MCPG), which is a structural analogue of HGA that can cause hypoglycaemic encephalopathy in humans. The active poison formed from MCPG is methylenecyclopropylformyl-CoA (MCPF-CoA). MCPF-CoA and MCPA-CoA strongly inhibit enzymes that participate in β-oxidation and energy production from fat. The aim of our study was to investigate if MCPG is involved in Acer seed poisoning in horses. MCPG, as well as glycine and carnitine conjugates (MCPF-glycine, MCPF-carnitine), were quantified using high-performance liquid chromatography-tandem mass spectrometry of serum and urine from horses that had ingested Acer pseudoplatanus seeds and developed typical AM symptoms. The results were compared to those of healthy control horses. For comparison, HGA and its glycine and carnitine derivatives were also measured. Additionally, to assess the degree of enzyme inhibition of β-oxidation, several acyl glycines and acyl carnitines were included in the analysis. In addition to HGA and the specific toxic metabolites (MCPA-carnitine and MCPA-glycine), MCPG, MCPF-glycine and MCPF-carnitine were detected in the serum and urine of affected horses. Strong inhibition of β-oxidation was demonstrated by elevated concentrations of all acyl glycines and carnitines, but the highest correlations were observed between MCPF-carnitine and isobutyryl-carnitine (r = 0.93) as well as between MCPA- (and MCPF-) glycine and valeryl-glycine with r = 0.96 (and r = 0.87). As shown here, for biochemical analysis of atypical myopathy of horses, it is necessary to take MCPG and the corresponding metabolites into consideration.
Topics: Acer; Animals; Chromatography, High Pressure Liquid; Cyclopropanes; Female; Glycine; Horse Diseases; Horses; Male; Metabolic Networks and Pathways; Muscular Diseases; Plant Poisoning; Seeds; Tandem Mass Spectrometry
PubMed: 30721263
DOI: 10.1371/journal.pone.0211698 -
The Indian Journal of Medical Research Jul 2009Cassia occidentalis is an annual shrub found in many countries including India. Although bovines and ovines do not eat it, parts of the plant are used in some... (Review)
Review
Cassia occidentalis is an annual shrub found in many countries including India. Although bovines and ovines do not eat it, parts of the plant are used in some traditional herbal medicines. Several animal studies have documented that fresh or dried beans are toxic. Ingestion of large amounts by grazing animals has caused serious illness and death. The toxic effects in large animals, rodents and chicken are on skeletal muscles, liver, kidney and heart. The predominant systems involved depend upon the animal species and the dose of the beans consumed. Brain functions are often affected. Gross lesions at necropsy consist of necrosis of skeletal muscle fibres and hepatic centrilobular necrosis; renal tubular necrosis is less frequent. Muscle and liver cell necrosis is reflected in biochemical abnormalities. The median lethal dose (LD(50)) is 1 g/kg for mice and rats. Toxicity is attributed to various anthraquinones and their derivatives and alkaloids, but the specific toxins have not been identified. Data on human toxicity are extremely scarce. This review summarizes information available on Cassia toxicity in animals and compares it with toxic features reported in children. The clinical spectrum and histopathology of C. occidentalis poisoning in children resemble those of animal toxicity, affecting mainly hepatic, skeletal muscle and brain tissues. The case-fatality rate in acute severe poisoning is 75-80 per cent in children.
Topics: Animals; Brain; Humans; India; Liver; Medicine, Traditional; Muscle, Skeletal; Senna Plant; Syndrome
PubMed: 19700797
DOI: No ID Found -
The Western Journal of Medicine Oct 1989
Topics: Child, Preschool; Fabaceae; Favism; Humans; Male; Plants, Medicinal
PubMed: 2588584
DOI: No ID Found -
Toxicon : Official Journal of the... Apr 2022Analytical detection of Oenanthe crocata toxins in biological samples is challenging because of their instability, the lack of commercially available standards and the...
Analytical detection of Oenanthe crocata toxins in biological samples is challenging because of their instability, the lack of commercially available standards and the exceptionally low detection of these molecules using mass spectrometry. This work aims to report the used analytical methods that allowed identification of the main plant toxins in biological samples from an equid (an Arabian horse) fatality related to hemlock water dropwort (Oenanthe crocata Linnaeus) intake. Using both LC-DAD and LC-HRMS methods allowed identification (i) of oenanthotoxin in roots found on the site, root fragments found in the stomach, stomach content, kidney, and liver, and (ii) of the hydrogenated metabolite of oenanthotoxin (2,3-dihydro-oenanthotoxin) in roots found on the site, root fragments found in the stomach, stomach content, kidney, liver and spleen. Reported analytical data about Oenanthe crocata toxins can be useful for identification of the ingested plant and for supporting a poisoning diagnosis in such cases.
Topics: Animals; Documentation; Horses; Mass Spectrometry; Oenanthe; Plant Poisoning; Toxins, Biological
PubMed: 35189181
DOI: 10.1016/j.toxicon.2022.02.009 -
Toxins Jun 2019Fescue toxicosis is a multifaceted syndrome that elicits many negative effects on livestock consuming ergot alkaloids produced by endophyte-infected tall fescue. The... (Review)
Review
Fescue toxicosis is a multifaceted syndrome that elicits many negative effects on livestock consuming ergot alkaloids produced by endophyte-infected tall fescue. The economic losses associated with fescue toxicosis are primarily due to reproductive failure including altered cyclicity, suppressed hormone secretion, reduced pregnancy rates, agalactia, and reduced offspring birth weights. For decades, a multitude of research has investigated the physiological and cellular mechanisms of these reproductive failures associated with fescue toxicosis. This review will summarize the various effects of ergot alkaloids on female reproduction in grazing livestock species.
Topics: Animals; Brain; Ergot Alkaloids; Female; Festuca; Lactation; Livestock; Ovary; Plant Poisoning; Pregnancy; Reproduction; Uterus
PubMed: 31234268
DOI: 10.3390/toxins11060364