Two Cases of Gelsemium Elegans Benth. Poisoning

Fung, HT; Lam, KK; Lam, SK; Wong, OF

doi:10.1177/102490790701400405

Cited by 13 publications

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“…Intentional or inadvertent adulteration of herbal products, including health food and dietary supplements, can cause adverse effects or even poisoning [ 1 - 6 ]. For instance, misidentification of the toxic vine Gelsemium elegans as Mussaenda pubescens (an ingredient of Chinese health drinks) caused two poisoning cases in Hong Kong [ 3 ]. Adulteration of the anti-inflammatory agent Stephania tetrandra by the toxic herb Aristolochia fangchi led to more than 100 cases of kidney failure and urothelial carcinoma in Belgium [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Identification of constituent herbs in ginseng decoctions by DNA markers

Shaw

2015

Chin Med

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BackgroundDNA in herbal decoctions is usually fragmented by extensive boiling and is usually regarded as unsuitable for molecular authentication. This study aims to evaluate the feasibility for molecular authentication methods by multiplex polymerase chain reaction (PCR) and DNA sequencing for decoctions.MethodsThe DNA extraction procedure, sample pulverization and boiling time were examined in (1) single herb decoction with Panax ginseng (“ginseng”) or P. quinquefolius (“American ginseng”), (2) decoctions of two classical ginseng prescriptions of five herbal materials (Aconitum carmichaeli, Atractylodes macrocephala, P. ginseng, Glycyrrhiza uralensis and Zingiber officinale) and (3) a commercial ready-to-serve ginseng soup. Primers were designed from 26S-18S, ITS2 and trnH-psbA region, with DNA sequences obtained from GenBank. Multiplex PCR was also employed in ginseng or American ginseng decoctions to differentiate between these two herbs.ResultsAll six herbal species tested in this study could be identified in decoctions. We had four main observations: (1) sample pulverization before boiling improved PCR detection; (2) prolonged boiling increased the DNA concentration but decreased the intactness of DNA fragments; (3) ginseng could be differentiated from American ginseng by multiplex PCR; (4) identification of individual herbs in multi-herb decoctions with prolonged boiling time of 180 min could be achieved.ConclusionsDNA could be amplified from extensively boiled ginseng decoctions, multi-herb decoctions and commercial soup although DNA degradation was critical to successful PCR.Electronic supplementary materialThe online version of this article (doi:10.1186/s13020-015-0029-x) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Identification of constituent herbs in ginseng decoctions by DNA markers

Shaw

2015

Chin Med

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“…To our knowledge, there are only four papers that involved the subject of G. elegans poisoning (summarized in Table 1) (1, 4–6). However, using the Chinese name of G. elegans as the search keyword, we found another 28 papers (7–34) that reported G. elegans poisoning cases in Wanfang Data, a major Chinese academic paper database of China.…”

Section: Discussionmentioning

confidence: 99%

“…Most of these cases are from collective food poisoning accidents due to mistaking G. elegans as non-toxic herbs (7, 8, 11–13, 15, 16, 22, 23, 25–29). The most common reason for G. elegans poisoning is mistaken ingestion, as its morphology is similar to some non-toxic Chinese medicinal herbs (1, 6). The second most common reason is suicide (10, 12, 14, 17, 18).…”

Section: Discussionmentioning

confidence: 99%

Gelsemium elegans Poisoning: A Case with 8 Months of Follow-up and Review of the Literature

Zhou

Zhong

et al. 2017

Front. Neurol.

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BackgroundGelsemium elegans (G. elegans) is a toxic plant indigenous to Southeast Asia. It is highly poisonous due to its strong respiratory depressive effect. However, G. elegans poisoning cases have not been summarized comprehensively and are rarely reported in English journals. Furthermore, none of the present reports present prognosis in detail.Case presentationA 26-year-old female was found comatose at home and brought to the hospital with deep coma, hypoxia, and acidosis. After mechanical ventilation for hours, the patient recovered from coma with sequelae of impaired short-term memory, disorientation, and childish behaviors. Brain magnetic resonance imaging (MRI) showed bilateral hippocampus and basal ganglia damage due to hypoxia. During 8 months of follow-up, both her symptoms and brain MRI scan improved significantly.ConclusionG. elegans is highly toxic. Although patients may die within 30 min due to its strong respiratory depressive effect, they can survive with timely respiratory support and enjoy gradual improvement without delayed postanoxic encephalopathy.

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“…Some of the cases have been previously published as case reports by the authors and other units. [12][13][14][15][16][17][18][19] Funding/support This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.…”

Section: Author Contributionsmentioning

confidence: 99%

“…4 Consumption of wild plants as "medicinal herbs" or food is not an uncommon practice in Hong Kong, and severe plant poisoning cases have been reported. [11][12][13][14][15][16][17][18][19] However, local epidemiology data on plant poisoning are ORIGINAL ARTICLE patients (n=61, 98%) used the plants intentionally: as a medicinal herb (n=31), as food (n=29), and for attempting suicide (n=1). Reasons for using the poisonous plants included misidentification (n=34, 55%), unawareness of the toxicity (n=20, 32%), and contamination (n=6, 10%).…”

Section: Introductionmentioning

confidence: 99%

Poisoning by toxic plants in Hong Kong: a 15-year review

Hung

Lam

et al. 2019

Hong Kong Med J

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has a great diversity of plants, many of which are toxic to humans. The aim of this study was to identify the plant species most commonly involved in cases of plant poisoning in Hong Kong and to provide clinicians with a reference tool for the diagnosis and management of plant poisoning. Methods: We retrospectively reviewed all plant poisoning cases referred to the Hospital Authority Toxicology Reference Laboratory from 1 January 2003 to 31 December 2017. Demographics, clinical presentation, laboratory findings, treatment and outcomes of patients, as well as morphological identification and analytical testing of the plant specimens, were investigated. Results: A total of 62 cases involving 26 poisonous plant species were identified, among which Alocasia macrorrhizos (Giant Alocasia), Gelsemium elegans (Graceful Jessamine), and Rhododendron (Azalea) species were the three most commonly encountered. Gastrointestinal toxicity (n=30, 48%), neurological toxicity (n=22, 35%), and hepatotoxicity (n=6, 10%) were the three most common clinical problems. Forty-nine (79%) and eight (13%) patients had mild and moderate toxicity, respectively; they all recovered shortly with supportive treatment. The remaining five (8%) patients experienced severe toxicity requiring intensive care support. Most

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Two Cases of Gelsemium Elegans Benth. Poisoning

Cited by 13 publications

References 0 publications

Identification of constituent herbs in ginseng decoctions by DNA markers

Identification of constituent herbs in ginseng decoctions by DNA markers

Gelsemium elegans Poisoning: A Case with 8 Months of Follow-up and Review of the Literature

Poisoning by toxic plants in Hong Kong: a 15-year review

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