Jha Bhaskar, Jha Apurwa, Karki Shailendra, Kc Pooja, Pandey Anish, Ghimire Abishkar, Acharya Bimarsh
Kathmandu Medical College, Sinamangal.
Gandaki Medical College , Pokhara ,Nepal.
Ann Med Surg (Lond). 2023 Dec 13;86(2):1120-1123. doi: 10.1097/MS9.0000000000001610. eCollection 2024 Feb.
Mad honey consumption is a common practice in Nepal for medicinal and consumption purposes, but it can lead to severe adverse effects. Grayanotoxin I and Grayanotoxin III isoforms found in rhododendron interfere with voltage-gated sodium channels resulting in gastrointestinal symptoms, and cardiovascular effects such as low blood pressure, abnormal heart rhythms, cardiac arrest, and abnormal electrical conduction in the heart, as well as rare central nervous system disorders. Here the authors report a case of Mad honey consumption leading to anaphylactic shock along with its investigations and management.
The authors present a case of a 51-year-old female who developed anaphylactic shock after consuming mad honey. The patient experienced symptoms including nausea, vomiting, abdominal pain, sweating, dizziness, facial and lip swelling, but no chest pain, loss of consciousness, abnormal body movement, or dyspnoea. The patient had no prior medical conditions, regular medications, or history of allergic reactions to honey or pollen.
Mad honey intoxication is caused by grayanotoxins, with distinct cardiac effects for different types of grayanotoxins. Symptoms include bradycardia, hypotension, abdominal pain, dizziness, and nausea, which subsided within 24 h following the initial management. The presence of grayanotoxin can be detected using specialized instrumentation, but it may not be available in all medical facilities. Co-intoxication with alcohol or propolis may also occur.
This case highlights the importance of recognizing and managing complications associated with mad honey consumption, particularly in regions where it is prevalent. Prompt medical attention is advised if unusual symptoms occur after honey consumption.
食用疯蜜在尼泊尔是一种常见的医疗和食用行为，但它可能会导致严重的不良反应。杜鹃花中发现的灰藜毒素I和灰藜毒素III亚型会干扰电压门控钠通道，导致胃肠道症状、心血管效应，如低血压、心律失常、心脏骤停和心脏异常电传导，以及罕见的中枢神经系统紊乱。在此，作者报告一例食用疯蜜导致过敏性休克及其检查和处理的病例。
作者报告一例51岁女性，食用疯蜜后发生过敏性休克。患者出现恶心、呕吐、腹痛、出汗、头晕、面部和嘴唇肿胀等症状，但无胸痛、意识丧失、身体异常运动或呼吸困难。患者既往无病史、规律用药，也无对蜂蜜或花粉过敏反应史。
疯蜜中毒由灰藜毒素引起，不同类型的灰藜毒素对心脏有不同影响。症状包括心动过缓、低血压、腹痛、头晕和恶心，初始处理后24小时内症状消退。可使用专门仪器检测灰藜毒素的存在，但并非所有医疗设施都有。也可能发生与酒精或蜂胶的共同中毒。
本病例强调了认识和处理与食用疯蜜相关并发症的重要性，特别是在疯蜜流行的地区。如果食用蜂蜜后出现异常症状，建议及时就医。
