Menezes Ritesh G, Usman Muhammad Shariq, Hussain Syed Ather, Madadin Mohammed, Siddiqi Tariq Jamal, Fatima Huda, Ram Pradhum, Pasha Syed Bilal, Senthilkumaran S, Fatima Tooba Qadir, Luis Sushil Allen
Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
J Forensic Leg Med. 2018 Aug;58:113-116. doi: 10.1016/j.jflm.2018.05.007. Epub 2018 May 9.
Cerbera odollam is a plant species of the Apocynaceae family. It is often dubbed the 'suicide tree' due to its strong cardiotoxic effects, which make it a suitable means to attempt suicide. The plant grows in wet areas in South India, Madagascar, and Southeast Asia; and its common names include Pong-Pong and Othalanga. The poison rich part of the plant is the kernel which is present at the core of its fruit. The bioactive toxin in the plant is cerberin, which is a cardiac glycoside of the cardenolide class. Cerberin has a mechanism of action similar to digoxin; hence, Cerbera odollam toxicity manifests similar to acute digoxin poisoning. Ingestion of its kernel causes nausea, vomiting, hyperkalemia, thrombocytopenia, and ECG abnormalities. Exposure to high doses of Cerbera odollam carries the highest risk of mortality. Initial management includes supportive therapy and administration of atropine followed by temporary pacemaker insertion. Administration of digoxin immune Fab may be considered in severe cases, although efficacy is variable and data limited to isolated case reports.
海芒果是夹竹桃科的一种植物。由于其具有强烈的心脏毒性作用，常被称为“自杀树”，这使其成为一种合适的自杀手段。这种植物生长在印度南部、马达加斯加和东南亚的湿润地区；其常见名称包括“海杧果”和“奥氏海芒果”。该植物富含毒素的部分是位于果实核心的果仁。植物中的生物活性毒素是海芒果毒素，它是强心甾类的一种强心苷。海芒果毒素的作用机制与地高辛相似；因此，海芒果中毒的表现类似于急性地高辛中毒。摄入其果仁会导致恶心、呕吐、高钾血症、血小板减少和心电图异常。接触高剂量的海芒果会带来最高的死亡风险。初始治疗包括支持性治疗和使用阿托品，随后插入临时起搏器。在严重病例中可考虑使用地高辛免疫Fab片段，尽管疗效不一且数据仅限于个别病例报告。
