Department of Cardiology, Bagcilar Education and Research Hospital, Istanbul, Turkey.
Clin Toxicol (Phila). 2010 Jul;48(6):528-32. doi: 10.3109/15563650.2010.497150.
Grayanotoxins (GTX), also known as andromedotoxins, are produced by plants of the Ericacae family. This toxin is responsible for "mad honey" intoxication, which can present with fatal cardiac bradyarrhythmias and circulatory collapse. GTXs lead to cardiac toxicity because they increase sodium channel permeability and activate the vagus nerve.
We evaluated 42 patients (33 males) prospectively who had been hospitalized with diagnosis of "mad honey" intoxication in a state hospital setting.
The median age of patients was 48.5 years and all patients were admitted with complaints of nausea, vomiting, dizziness, fainting, and sweating. Five of the patients had syncope before admission. On admission, the mean systolic blood pressure was 73.1 ± 12.7 mmHg, the mean diastolic blood pressure was 52.1 ± 11.3 mmHg, mean heart rate was 38 ± 7 bpm. On initial electrocardiograms, 18 patients had sinus bradycardia, 15 patients had complete atrioventricular block, and 9 patients had nodal rhythm. All patients were monitored in a coronary care unit and treated symptomatically with atropine, intravenous fluids, and dopamine. None of the patients needed temporary pacing and all were discharged without complications.
"Mad honey," which is produced widely in northern parts of Turkey can be toxic. This intoxication should be considered in patients admitted to emergency department with bradycardia and hypotension especially in regions where this honey is produced.
格雷氨毒素（GTX），也称为安杜马毒素，由石南科植物产生。这种毒素是导致“疯蜜”中毒的原因，可导致致命性的心脏缓慢性心律失常和循环衰竭。GTX 导致心脏毒性，是因为它增加了钠离子通道的通透性并激活了迷走神经。
我们前瞻性评估了 42 名（33 名男性）因在州立医院诊断为“疯蜜”中毒而住院的患者。
患者的中位年龄为 48.5 岁，所有患者均因恶心、呕吐、头晕、晕厥和出汗而入院。5 名患者在入院前出现晕厥。入院时，平均收缩压为 73.1±12.7mmHg，平均舒张压为 52.1±11.3mmHg，平均心率为 38±7bpm。在初始心电图上，18 例窦性心动过缓，15 例完全性房室传导阻滞，9 例结性节律。所有患者均在冠心病监护病房监测，并接受阿托品、静脉补液和多巴胺对症治疗。所有患者均无需临时起搏，且均无并发症出院。
在土耳其北部广泛生产的“疯蜜”可能有毒。在生产这种蜂蜜的地区，急诊科出现心动过缓和低血压的患者应考虑这种中毒。
