Kosaki Yoshinori, Naito Hiromichi, Nojima Tsuyoshi, Nakao Atsunori
Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Case Rep Emerg Med. 2020 Jan 28;2020:5072954. doi: 10.1155/2020/5072954. eCollection 2020.
The ginkgo tree is a well-known, highly adaptable urban plant. Ginkgo nuts are the product of the ginkgo tree. Interior ginkgo nuts are cooked and served in Asian countries; however, the potential toxicity of the gingko nuts is not commonly known. Herein, we report a 48-year-old male patient experiencing acute convulsions presumably due to overconsumption of gingko nuts. The patient was transferred to our department after several episodes of acute generalized tonicclonic seizures lasting approximately 30 seconds each and starting one hour before the visit. The patient also complained of vomiting, vertigo, diarrhea, and tremors in both upper limbs following the seizures. Elevated 4-O-methylpyridoxine (312 ng/mL), low blood pyridoxal phosphate (2.4 g/L), and low vitamin B1 (20 ng/mL) levels were found in the blood analysis. No other remarkable abnormalities were detected. We diagnosed the patient with ginkgo nut intoxication, and he was orally administered 400 mg of pyridoxal phosphate. His symptoms resolved after treatment, and no seizures recurred thereafter. Our report may help raise awareness of the clinical presentation and management of this intoxication among emergency physicians.
银杏树是一种广为人知、适应性很强的城市植物。银杏果是银杏树的产物。在亚洲国家，银杏果的果仁会经过烹饪后食用；然而，银杏果潜在的毒性却并不为大众所熟知。在此，我们报告一例48岁男性患者，其急性惊厥可能是由于过量食用银杏果所致。该患者在就诊前一小时开始出现数次急性全身性强直阵挛发作，每次发作持续约30秒，随后被转至我院。患者在发作后还伴有呕吐、眩晕、腹泻以及双侧上肢震颤。血液分析显示4 - O - 甲基吡哆醇水平升高（312 ng/mL）、血磷酸吡哆醛水平降低（2.4 g/L）以及维生素B1水平降低（20 ng/mL）。未检测到其他明显异常。我们诊断该患者为银杏果中毒，并给予其口服400 mg磷酸吡哆醛。治疗后其症状缓解，此后未再发作。我们的报告可能有助于提高急诊医生对这种中毒临床表现及处理的认识。
