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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...

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Autores principales: 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
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
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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.
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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
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