Osterloh J, Herold S, Pond S
JAMA. 1982 Mar 19;247(11):1596-7.
An elderly woman allegedly ingested oleander leaves and died. Ventricular arrhythmias and asystole were unresponsive to cardiopulmonary resuscitation, pharmacologic agents, and cardioversion. The patient, who had no access to digoxin, had an initial serum digoxin concentration of 5.8 ng/mL. Cross-reactivities between oleander extract and pure oleandrin and digoxin in the digoxin radioimmunoassay were 100:1 and 29,000:1, respectively. We postulate that glycosides in oleander leaves produced the elevated serum digoxin concentration. Based on an assumed volume of distribution of the oleander glycosides of 1 L/kg, the calculated lethal dose absorbed by our patient was 200 times greater than lethal doses in several animal species and corresponded to the absorption of 4 g of oleander leaves.
一名老年女性据称摄入夹竹桃叶子后死亡。心室心律失常和心搏停止对心肺复苏、药物治疗及心脏复律均无反应。该患者未接触过地高辛，初始血清地高辛浓度为5.8 ng/mL。夹竹桃提取物与纯夹竹桃苷及地高辛在放射免疫分析中的交叉反应率分别为100:1和29000:1。我们推测夹竹桃叶子中的糖苷导致血清地高辛浓度升高。基于夹竹桃苷1 L/kg的假定分布容积，计算出我们的患者吸收的致死剂量比几种动物的致死剂量大200倍，相当于吸收了4 g夹竹桃叶子。
