Cargando…
A Case Report of Accidental Intoxication following Ingestion of Foxglove Confused with Borage: High Digoxinemia without Major Complications
Foxglove (Digitalis purpurea L.) leaves are frequently confused with borage (Borago officinalis L.), which is traditionally used as a food ingredient. Due to the presence of the cardiac glycosides, mostly digitoxin, foxglove leaves are poisonous to human and may be fatal if ingested. A 55-year-old C...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906804/ https://www.ncbi.nlm.nih.gov/pubmed/31871798 http://dx.doi.org/10.1155/2019/9707428 |
_version_ | 1783478421541617664 |
---|---|
author | Negroni, Maria Silvia Marengo, Arianna Caruso, Donatella Tayar, Alessandro Rubiolo, Patrizia Giavarini, Flavio Persampieri, Simone Sangiovanni, Enrico Davanzo, Franca Carugo, Stefano Colombo, Maria Laura Dell'Agli, Mario |
author_facet | Negroni, Maria Silvia Marengo, Arianna Caruso, Donatella Tayar, Alessandro Rubiolo, Patrizia Giavarini, Flavio Persampieri, Simone Sangiovanni, Enrico Davanzo, Franca Carugo, Stefano Colombo, Maria Laura Dell'Agli, Mario |
author_sort | Negroni, Maria Silvia |
collection | PubMed |
description | Foxglove (Digitalis purpurea L.) leaves are frequently confused with borage (Borago officinalis L.), which is traditionally used as a food ingredient. Due to the presence of the cardiac glycosides, mostly digitoxin, foxglove leaves are poisonous to human and may be fatal if ingested. A 55-year-old Caucasian woman complaining weakness, fatigue, nausea, and vomiting was admitted to the Emergency Department. Her symptoms started following consumption of a home-made savory pie with 5 leaves from a plant bought in a garden nursery as borage. Digoxinemia was high (10.4 μg/L). The patient was admitted to the cardiac intensive care unit for electrocardiographic monitoring. Two days after admission, a single episode of advanced atrioventricular (AV) block was recorded by telemetry, followed by a second-degree AV block episode. Plasma samples at day 11 were analysed by LC-MS spectrometry, and gitoxin was identified suggesting that this compound may be responsible for the clinical toxicity rather than digoxin. In the case of Digitalis spp. poisoning, laboratory data should be interpreted according to the clinical picture and method of analysis used since a variety of glycosides, which are chemically similar to the cardioactive glycosides but without or with fewer cardiac effects, may be incorrectly recognized as digoxin by the test, giving misleading results. |
format | Online Article Text |
id | pubmed-6906804 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-69068042019-12-23 A Case Report of Accidental Intoxication following Ingestion of Foxglove Confused with Borage: High Digoxinemia without Major Complications Negroni, Maria Silvia Marengo, Arianna Caruso, Donatella Tayar, Alessandro Rubiolo, Patrizia Giavarini, Flavio Persampieri, Simone Sangiovanni, Enrico Davanzo, Franca Carugo, Stefano Colombo, Maria Laura Dell'Agli, Mario Case Rep Cardiol Case Report Foxglove (Digitalis purpurea L.) leaves are frequently confused with borage (Borago officinalis L.), which is traditionally used as a food ingredient. Due to the presence of the cardiac glycosides, mostly digitoxin, foxglove leaves are poisonous to human and may be fatal if ingested. A 55-year-old Caucasian woman complaining weakness, fatigue, nausea, and vomiting was admitted to the Emergency Department. Her symptoms started following consumption of a home-made savory pie with 5 leaves from a plant bought in a garden nursery as borage. Digoxinemia was high (10.4 μg/L). The patient was admitted to the cardiac intensive care unit for electrocardiographic monitoring. Two days after admission, a single episode of advanced atrioventricular (AV) block was recorded by telemetry, followed by a second-degree AV block episode. Plasma samples at day 11 were analysed by LC-MS spectrometry, and gitoxin was identified suggesting that this compound may be responsible for the clinical toxicity rather than digoxin. In the case of Digitalis spp. poisoning, laboratory data should be interpreted according to the clinical picture and method of analysis used since a variety of glycosides, which are chemically similar to the cardioactive glycosides but without or with fewer cardiac effects, may be incorrectly recognized as digoxin by the test, giving misleading results. Hindawi 2019-11-29 /pmc/articles/PMC6906804/ /pubmed/31871798 http://dx.doi.org/10.1155/2019/9707428 Text en Copyright © 2019 Maria Silvia Negroni et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Negroni, Maria Silvia Marengo, Arianna Caruso, Donatella Tayar, Alessandro Rubiolo, Patrizia Giavarini, Flavio Persampieri, Simone Sangiovanni, Enrico Davanzo, Franca Carugo, Stefano Colombo, Maria Laura Dell'Agli, Mario A Case Report of Accidental Intoxication following Ingestion of Foxglove Confused with Borage: High Digoxinemia without Major Complications |
title | A Case Report of Accidental Intoxication following Ingestion of Foxglove Confused with Borage: High Digoxinemia without Major Complications |
title_full | A Case Report of Accidental Intoxication following Ingestion of Foxglove Confused with Borage: High Digoxinemia without Major Complications |
title_fullStr | A Case Report of Accidental Intoxication following Ingestion of Foxglove Confused with Borage: High Digoxinemia without Major Complications |
title_full_unstemmed | A Case Report of Accidental Intoxication following Ingestion of Foxglove Confused with Borage: High Digoxinemia without Major Complications |
title_short | A Case Report of Accidental Intoxication following Ingestion of Foxglove Confused with Borage: High Digoxinemia without Major Complications |
title_sort | case report of accidental intoxication following ingestion of foxglove confused with borage: high digoxinemia without major complications |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906804/ https://www.ncbi.nlm.nih.gov/pubmed/31871798 http://dx.doi.org/10.1155/2019/9707428 |
work_keys_str_mv | AT negronimariasilvia acasereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT marengoarianna acasereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT carusodonatella acasereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT tayaralessandro acasereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT rubiolopatrizia acasereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT giavariniflavio acasereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT persampierisimone acasereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT sangiovannienrico acasereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT davanzofranca acasereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT carugostefano acasereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT colombomarialaura acasereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT dellaglimario acasereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT negronimariasilvia casereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT marengoarianna casereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT carusodonatella casereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT tayaralessandro casereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT rubiolopatrizia casereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT giavariniflavio casereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT persampierisimone casereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT sangiovannienrico casereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT davanzofranca casereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT carugostefano casereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT colombomarialaura casereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications AT dellaglimario casereportofaccidentalintoxicationfollowingingestionoffoxgloveconfusedwithboragehighdigoxinemiawithoutmajorcomplications |