Sado Tomomitsu, Nakata Setsuko, Tsuno Takahisa, Sato Masanori, Misawa Yuka, Yamauchi Shoko, Inaba Yuji, Kobayashi Daisuke, Wada Keiji
Department of Pediatrics, Matsumoto Municipal Hospital, Japan.
Department of Pediatrics, Matsumoto Municipal Hospital, Japan.
Brain Dev. 2019 Mar;41(3):292-295. doi: 10.1016/j.braindev.2018.10.007. Epub 2018 Oct 23.
A 2-year-old girl required medical attention for a sudden onset of repetitive tonic-clonic convulsions after ingesting 20-30 ginkgo seeds. Concentrations of the major forms of circulating vitamin B, pyridoxal-5'-phosphate (PLP), pyridoxal (PL), and 4-pyridoxic acid, as well as the known ginkgo seed toxin 4'-O-methylpyridoxine (MPN) were measured in the serum and cerebrospinal fluid (CSF). PLP is an active form of vitamin B and necessary for γ-aminobutyric acid (GABA) production. High MPN concentrations were observed in both the serum and CSF. As the PLP to PL ratio was markedly decreased in serum and CSF examinations, we suspected the ratio to be important in GABA production. This case report provides novel information on the metabolism of vitamin B in humans as a result of ginkgo seed poisoning.
一名2岁女童在摄入20 - 30颗银杏种子后突然出现反复的强直性阵挛性惊厥，需要就医治疗。检测了血清和脑脊液（CSF）中循环维生素B的主要形式、磷酸吡哆醛（PLP）、吡哆醛（PL）和4 - 吡哆酸的浓度，以及已知的银杏种子毒素4'-O-甲基吡哆醇（MPN）。PLP是维生素B的活性形式，是γ-氨基丁酸（GABA）产生所必需的。在血清和脑脊液中均观察到高浓度的MPN。由于血清和脑脊液检查中PLP与PL的比值明显降低，我们怀疑该比值在GABA产生中很重要。本病例报告提供了关于银杏种子中毒导致人体维生素B代谢的新信息。
