University of Southern California, Department of Emergency Medicine, Los Angeles, CA, United States of America; University of California, Irvine, Department of Emergency Medicine, Orange, CA, United States of America; Chapman University, School of Pharmacy, Irvine, CA, United States of America.
Northridge Hospital Medical Center, Emergency Department, Northridge, CA, United States of America.
Am J Emerg Med. 2020 Aug;38(8):1698.e5-1698.e6. doi: 10.1016/j.ajem.2020.04.063. Epub 2020 Apr 21.
Cerbera odollam or "pong-pong" tree contains cardiac glycosides similar to digoxin, oleander and yellow oleander. Cerbera odollam is a common method of suicide in South East Asia and has also been used as a weight loss supplement. We present a case of a 33-year-old female presenting with lethargy, vomiting, bradycardia, severe hyperkalemia of 8.9 mEq/L, slow atrial fibrillation followed by cardiovascular collapse following the ingestion of "pong-pong", the kernel of Cerbera odollam, as a weight loss supplement. Despite the administration of a total of nine vials of digoxin-specific Fab the patient could not be resuscitated. Clinicians should be aware of natural cardiac glycosides being uses as weight-loss agents and consider acute cardiac glycoside poisoning in patients with hyperkalemia, abnormal cardiovascular signs, symptoms and abnormal ECG findings.
海杧果或“砰砰”树含有与地高辛、夹竹桃和黄花夹竹桃相似的强心苷。海杧果是东南亚常见的自杀方法，也被用作减肥补充剂。我们报告了一例 33 岁女性，因乏力、呕吐、心动过缓、严重高钾血症（8.9 mEq/L）、缓慢心房颤动，随后在摄入海杧果（Cerbera odollam 的内核）作为减肥补充剂后出现心血管崩溃。尽管总共给予了九瓶地高辛特异性 Fab，但患者仍无法复苏。临床医生应注意天然强心苷被用作减肥药，并应考虑到患有高钾血症、心血管异常迹象、症状和异常心电图发现的患者出现急性强心苷中毒。
