Tranca Sebastian, Petrisor Cristina Laura
Department of Anaesthesiology and Intensive Care, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Clujul Med. 2013;86(3):279-81. Epub 2013 Aug 5.
Taxine-derived alkaloids, taxane-derived substances, and glycosides seem to be responsible for the toxicity of Taxus spp. by blocking microtubule, sodium and calcium channels causing conduction abnormalities. Cases with Taxus baccata acute intoxication have rarely been reported.
We report the case of a 43-year-old man who ingested, for suicidal purposes, common (or European) yew leaves (Taxus baccata) and presented severe hypokalemia, ventricular arrhythmias with hemodynamic instability accompanied by severe multiple organ dysfunction syndrome, including respiratory insufficiency, renal failure, acid-base imbalance with severe hypokalemia, hepatic dysfunction and coma, which led to death 12 hours after Taxus baccata ingestion.
In this particular case, the cardiac electrical instability was definitely maintained by several causes, including severe hypokalemia, which has not been previously reported as related to Taxus poisoning. The metabolic acidosis associated with severe hypokalemia definitely contributed to the complex arrhythmias. The occurrence of severe hypokalemia needs further attention in cases with Taxus poisoning as its immediate treatment might increase survival chances.
紫杉碱衍生的生物碱、紫杉烷衍生的物质和糖苷似乎是红豆杉属植物毒性的原因,它们通过阻断微管、钠通道和钙通道导致传导异常。欧洲红豆杉急性中毒的病例鲜有报道。
我们报告了一例43岁男性的病例,该男子出于自杀目的摄入了欧洲红豆杉的叶子,出现了严重低钾血症、伴有血流动力学不稳定的室性心律失常,并伴有严重的多器官功能障碍综合征,包括呼吸功能不全、肾衰竭、伴有严重低钾血症的酸碱失衡、肝功能障碍和昏迷,在摄入欧洲红豆杉叶子12小时后死亡。
在这个特殊病例中,心脏电不稳定肯定是由多种原因维持的,包括严重低钾血症,此前尚未报道其与红豆杉中毒有关。与严重低钾血症相关的代谢性酸中毒肯定促成了复杂的心律失常。在红豆杉中毒病例中,严重低钾血症的发生需要进一步关注,因为其及时治疗可能会增加存活几率。