Fatal Yellow Oleander Poisoning Masquerading as Benign Candlenut Ingestion Taken for Weight Loss

Corcoran, Justin N; Gray, Ted; Bangh, Stacey A.; Singh, Veena; Cole, Jon B.

doi:10.1016/j.jemermed.2020.07.026

Cited by 8 publications

(7 citation statements)

References 10 publications

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“…The emergency physician contacted the Maryland Poison Center (MPC), and cardiac glycoside poisoning was suspected from the clinical picture 12 . Upon investigation of the case, MPC personnel discovered a recent article describing a case of suspected yellow oleander poisoning 13,14 and promptly administered anti-digoxin antidote 15 . This intervention resulted in rapid improvement in bradycardia.…”

Section: Resultsmentioning

confidence: 99%

“…Our local hospital had 8 vials on hand, and administered all in order to treat the patient. The tragic case in Minnesota is especially sobering: while the patient was in the intensive care unit, her clinical team found their facility had only 5 vials on hand and was calling other hospitals to secure additional doses (because treating yellow oleander poisoning is thought to require 10-20 times the regular dose 15 ) when the patient suddenly died 13 . In the end, it was discovered that the entire city had no more than 20 doses on hand, which may be enough to save only one or two poisoned residents.…”

Section: Discussionmentioning

confidence: 99%

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Food fraud: insights from investigating a near-fatal poisoning with global implications

Cao,

Yemets,

Muneem

et al. 2023

Preprint

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SUMMARYRisks of food fraud have been exacerbated by ongoing supply-chain shortages and reduced regulatory oversight caused by the COVID19 pandemic. Since food fraud cases involve adulterants that are deliberately disguised, resulting poisonings are especially difficult to investigate and treat. We encountered a near-fatal poisoning with “weight-loss candlenuts” that are readily available online. We leveraged state-of-the-art high-resolution mass spectrometry (HRMS) and discovered that commonly used spectral libraries and toxin/poison standards panels do not contain the materials needed to identify the causative agents of this nearly lethal poisoning. By building new methods, we ultimately found ‘Nuez de la India’ contain high levels of uncommon cardiac glycosides, while deploying HRMS as a novel ‘chemical fingerprinting’ tool revealed them to be mislabeled yellow oleander seeds. Our work presents a rapid investigative strategy to empower future investigations, and provides guiding principles to food safety programs for treating, and indeed preventing, these potentially fatal poisonings that are increasing worldwide.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Food fraud: insights from investigating a near-fatal poisoning with global implications

Cao,

Yemets,

Muneem

et al. 2023

Preprint

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“…On the other hand, candlenut seeds contain phorbol ester and saponin, the two most plenteous substances found in candlenut seeds that are responsible for their toxicity (Corcoran et al 2020;Lawani and Winter 2022). Phorbol ester is a toxic diterpene generally found in Euphorbiaceae and Thymelaceae.…”

Section: Introductionmentioning

confidence: 99%

“…Phorbol ester is a toxic diterpene generally found in Euphorbiaceae and Thymelaceae. Candlenut seed is usually consumed as an herbal medicine for weight loss, could cause vomiting, diarrhea, gastrointestinal nuisance, cardiac arrest, and also death (González-Stuart and Rivera 2019;Corcoran et al 2020;Rosa et al 2022;Lawani and Winter 2022); due to its adverse effects. Maximum intake at ≥2 g/kg BW did not cause any mortality (de Castilho et al 2021).…”

Section: Introductionmentioning

confidence: 99%

Effects of the candlenut seed oil supplementation on the fatty acids profile of Swiss Webster mice

WONGGO,

AGUSTIN,

WONGSO

et al. 2023

Asian J Nat Prod Biochem

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Abstract. Wonggo D, Agustin YC, Wongso S, Putra SED. 2023. Effects of the candlenut seed oil supplementation on the fatty acids profile of Swiss Webster mice. Asian J Nat Prod Biochem 21: 26-33. Candlenut (Aleurites moluccana (L.) Wild) is a widely distributed plant in Asia and Australia. Previous studies show the benefits of consuming foods containing Unsaturated Fatty Acids (UFA) that can reduce saturated fatty acids in the body. However, to date, there has been on the effect of candlenut seed oil on Fatty Acid (FA) profile, so this study intended to determine the highest candlenut seed oil supplemented to feed/food ingredients and its effect on unsaturated and Saturated Fatty Acids (SFA) profile in the blood and adipose tissue. Thirty-two Swiss Webster mice were divided into 2 groups, Group I (control group, n=16) was given normal (regular) feed, and Group II (test group, n=16) was assigned 16% candlenut seed oil-supplemented feed. The experiment was carried out for 13 weeks. At the end of the study (week 13th), the mice were dissected, and the fatty acids profile from the adipose was analyzed using a GC-FID instrument. Supplementation of 16% candlenut seed oil in feed increases total fat content to 180%, decreases Saturated Fatty Acids (SFA) to 17,71%, and increases unsaturated fatty acids (UFA) to 82,29%. Mice treated with 16% candlenut seed oil in the feed for 13 weeks showed a significant reduction in SFA level (38,975% ± 11,178 vs. 22,148% ± 2,853, p<0,05), accompanied by a significant increase in UFA (60,633% ± 10,924 vs. 77,693% ± 2,685, p<0,05). In addition, a significant increase in linolenic acid (1,1% ± 0,572 vs. 7,925% ± 1,305, p<0,05) and the UFA with more than one double bond (Linoleic acid and Linolenic acid) (26,65% ± 8,783 vs. 42,245% ± 2,322, p<0,05). Regular consumption of candlenut seed oil could increase UFA levels and decrease SFA levels. Therefore, candlenut seed oil might be the potential as a food additive to maintain health.

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“…These compounds are known to present mostly antinociceptive and anti-inflammatory activity [ 8 , 9 ]. On the other hand, the esters and saponins found in AM seeds can cause vomiting and diarrhea as adverse effects [ 10 ]. The seed of the plant has gained notoriety as a fast weight-loss agent, despite the scarcity of information about its pharmacological mechanisms of action.…”

Section: Introductionmentioning

confidence: 99%

Fatty acids composition and in vivo biochemical effects of Aleurites moluccana seed (Candlenut) in obese wistar rats

Rosa

Ribeiro

Silva

et al. 2022

Diabetol Metab Syndr

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Background Candlenut (CN) has been used indiscriminately for weight loss. In vivo effects of CN in different doses are scarce. Objective To evaluate the effects of CN ingestion in obese rats. Design Thirty animals (obese and non-obese) received one of three different types of treatments: placebo, CN ingestion in a popular therapeutic regimen (8 days with oral administration of 0.2 mg/kg followed by 20 days with doses of 0.4 mg/kg), and ingestion of a doubled popular dose—called 2CN. Treatment was maintained for 28 days. Results The fatty acid profile of CN indicated mainly linolelaidic and palmitoleic acids. Rats receiving CN and 2CN showed reduced plasmatic levels of glucose and lipoproteins (p < 0.05). A dose-dependent carcass fat reduction was observed (p < 0.05). Blood levels of aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT) reduced with CN and increased with 2CN doses (p < 0.05). Alanine aminotransferase (ALT) and the atherogenic index remained similar among all treatments (p > 0.05). Hepatic vacuolation decreased with CN, but the 2CN dose produced mononuclear leucocyte infiltrate. Conclusions Although CN presented beneficial effects on the metabolism of rats, it also caused increased risk of liver damage.

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Fatal Yellow Oleander Poisoning Masquerading as Benign Candlenut Ingestion Taken for Weight Loss

Cited by 8 publications

References 10 publications

Food fraud: insights from investigating a near-fatal poisoning with global implications

Food fraud: insights from investigating a near-fatal poisoning with global implications

Effects of the candlenut seed oil supplementation on the fatty acids profile of Swiss Webster mice

Fatty acids composition and in vivo biochemical effects of Aleurites moluccana seed (Candlenut) in obese wistar rats

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