Outfoxed’ – Out of Season

Outfoxed’ – Out of Season

A 65 year old woman presented to the Emergency Department of our district general hospital three hours following ingestion of a blended mixture of apples and foxglove leaves, mistaking them for spinach leaves. She complained of nausea, vomiting, abdominal cramps, dizziness and blurred vision.
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References

  1. Lori S. Newman, Mark W. Feinberg, Howard E. LeWine. A Bitter tale. N Engl J Med 2004; 351: 594–9.
  2. R J I Bain. Accidental digitalis poisoning due to drinking herbal tea. Case report. BMJ 1985; 290: 1624.
  3. Nigel I Jowett. Foxglove poisoning. Case report. Hospital Medicine. Dec 2002, Vol 63, No 12.
  4. Dickstein ES, Kunkel FW. Foxglove tea poisoning. Am J Med. 1980 Jul; Vol 69 (1): 167–9.
  5. Nancy R. Slifman, William R. Obermeyer, Brenda K. Aloi, et al. Contamination of Botanical Dietary Supplements by Digitalis Lanata. N Engl J Med. 1998; 339(12): 806–11.
  6. Fermin Barrueto, Saeed A. Jortani, R. Valdes, et al. Cardioactive steroid poisoning from an Herbal Cleansing preparation. Ann Emerg Med. 2003; 41: 396–399.
  7. Steven A. Rich, Joyce M. Libera, Robert J. Locke. Treatment of Foxglove extract poisoning with Digoxin-specific Fab Fragments. Ann Emerg Med 1993; 22: 1904–1907.
  8. Stephane Thierry, Francois Blot, Jean-Claude Lacherade, et al. Poisoning with foxglove extract: Favourable evolution without Fab fragments. Intensive care Med 2000; 26: 1586.
  9. A Hollman. Plants and cardiac glycosides. Br Heart J. 1985; 54: 258–61.
  10. Package insert. MULTIGENT® Digoxin assay. ARCHITECT®/ EROSET® REF 1E06–20.ss
  11. M. Regina Litonjua, Stephanie Penton, Craig Robinson, et al. Digoxin: The Monarch of cardiac toxicities. Journal of pharmacy practice 2005. 18; 157–168.
  12. Antman EM, Wenger TL, Butler VP. Jr, et al. Treatment of 150 cases of life-threatening digitalis intoxication with digitoxin-specific Fab antibody fragments. Final report. Circulation 1990; 81: 1744–1752.
  13. Robert J. Flanagan, Alison L. Jones. Fab Antibody Fragments. Some applications in clinical toxicology. Review article. Drug safety 2004; 27(14): 1115–1133.
  14. Alan Spiegel, Francis E. Marchlinski. Time course for reversal of digoxin toxicity with digoxin-specific antibody fragments. American Heart Journal. June 1985; 109(6): 1397–1399.
  15. Smith TW, Butler VP Jr, Haber E. Characterisation of antibodies of high affinity and specificity for digitalis glycoside digoxin. Biochemistry 1970; 9: 331–337.
  16. Eddleston M, Rajapakse S, Rajakanthan Jayalath S, et al. Anti-digoxin Fab fragments in cardiotoxicity induced by ingestion of yellow oleander: a randomised controlled trial. Lancet 2000; 355: 967–72.

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Outfoxed’ – Out of Season

1st March 2016
PMID: 21611574
Authors Affiliations
M Imran Khan M.B.B.S, F.C.P.S, M.R.C.P, M.M.Sc. Registrar department of medicine Our Lady’s hospital Navan. Ireland.
A Callaghan MB,BCH. Senior House officer department of medicine Our Lady’s hospital Navan. Ireland
EK Eltayeb M.B.B.S, M.R.C.P. Registrar department of medicine Our Lady’s hospital Navan. Ireland.
John G Kelly Professor of pharmacology. School of pharmacy. Royal College of Surgeons Dublin Ireland
K McGarry Consultant Physician. Our Lady’s hospital Navan. Ireland.

Outfoxed’ – Out of Season

Cite this article as:

Khan I, Callaghan A, Eltayab EK, Kelly JG, McGarry K. 'Outfoxed' - out of season. Acute Med. 2008;7(2):83-6. PMID: 21611574.

Outfoxed’ – Out of Season

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