Giménez Nuria, Magro Noemí, Cortés Nuria, Guitart Raimon
Research Unit, Mútua Terrassa Research Foundation, Universitat de Barcelona, Spain; Toxicology Laboratory, Universitat Autònoma de Barcelona, Spain.
Department of Pediatrics, Hospital Universitari MútuaTerrassa, Mútua Terrassa Research Foundation, Universitat de Barcelona, Barcelona, Spain; CAP Can Matas, Mútua Terrassa, Barcelona, Spain.
J Emerg Med. 2017 Sep;53(3):e41-e44. doi: 10.1016/j.jemermed.2017.04.033.
Spanish broom (Spartium junceum L.) is an ornamental, medicinal, and potentially poisonous plant.
Three children, aged 5-6 years, were accidentally poisoned from ingesting a variable number of seeds of Spanish broom. This plant contains several quinolizidine alkaloids as cytisine, which act as an agonist of nicotinic acetylcholine receptors. The potential danger varies, depending on the dose. After having ingested one to two seeds, one of the boys was asymptomatic. A second boy ingested four to five seeds and presented some digestive problems with favorable clinical evolution. A third boy ingested seven to eight seeds, and presented with digestive and neurologic symptoms, as well as minor metabolic acidosis. In this case there was vomiting with remains of the seeds. He responded well to a gastric lavage and activated charcoal. He was discharged 24 h post ingestion. The intake within one to eight seeds was accompanied by moderate symptoms, with good response to treatment. Children poisoned by plants with nicotine-like symptomatology usually fully recover, but some fatal cases have been reported. Prevention is always a key aspect to consider so as to reduce the risk of poisoning. There is a lack of legislative measures, based on lists provided by experts, to regulate real or potentially poisonous plants in children's areas. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case serves as an example of accidental plant poisoning. For emergency physicians, it is usually complicated to identify the specific plant involved, so initial treatment often starts with basic measures (airway, breathing, and circulation).
西班牙金雀花（Spartium junceum L.）是一种观赏性、药用且有潜在毒性的植物。
三名5至6岁的儿童因误食数量不等的西班牙金雀花种子而意外中毒。这种植物含有多种喹诺里西啶生物碱，如金雀花碱，它作为烟碱型乙酰胆碱受体的激动剂。潜在危险因剂量而异。其中一名男孩误食一到两粒种子后无症状。第二名男孩误食四到五粒种子，出现了一些消化问题，但临床进展良好。第三名男孩误食七到八粒种子，出现了消化和神经症状，以及轻度代谢性酸中毒。在这个病例中，男孩出现了呕吐，呕吐物中有种子残渣。他接受洗胃和活性炭治疗后反应良好。摄入后24小时出院。摄入一到八粒种子会伴有中度症状，对治疗反应良好。因具有类似尼古丁症状的植物中毒的儿童通常能完全康复，但也有一些致命病例的报道。预防始终是需要考虑的关键方面，以降低中毒风险。基于专家提供的清单，缺乏立法措施来监管儿童区域内实际或潜在有毒的植物。
为什么急诊医生应该了解这个情况？：这个病例是意外植物中毒的一个例子。对于急诊医生来说，识别具体涉及的植物通常很复杂，所以初始治疗往往从基本措施（气道、呼吸和循环）开始。
