World's first medical networking and resource portal

Articles
Category : All
Medical Articles
Jul19
YELLOW OLEANDER (THEVETIA PERUVIANA) POISONING PRESENTING WITH INTRAVASCULAR HEMOLYSIS AND RENAL FAILURE: A RARE CASE REPORT
Yellow oleander (Thevetia peruviana family Apocynaceae) is an ornamental plant; with yellow bell shaped flowers and is a tree native to Mediterranean (5, 13). The fruit is globular light green about 4-5 cm in diameter and contain a single nut which is triangular with a deep groove along the edge. Each nut contains five pale yellow seeds (4). Since ancient times it has been known toxic to humans. It has been used by Africans as an arrow poison, Greeks believed it to be poisonous to “all four footed beasts” (5). All parts of the plant are poisonous especially seeds, stems, and roots with highest toxin concentration occurring during the peak flowering stages (5). Various toxins, which are cardiac glycosides chemically, have been isolated; oleandrin, digitoxigenin, nerium folinerium, rosagenin, theventin A & B thevetoxin, peruvoside, ruvoside, cerberin, oleandroside, and also a bitter principle that act on the CNS and produces tetanoid convulsions(3,4,6,10,15). They have digoxin like effect by inhibiting Na+K+ ATPase pump (6,13). The highest oleandrin concentrations are found in the leaves (6). The clinical presentation usually resembles digoxin poisoning with gastrointestinal symptoms (Nausea, vomiting and mucosal erythema) and cardiovascular complications (bradydysrhythmias, sinus bradycardia with all types of AV nodal block, junctional rhythms, and sinus arrest, tachydysrhythmias, such as atrial tachycardia with block, Junctional tachycardia, Ventricular tachycardia, Ventricular fibrillation, Paroxysmal atrial tachycardia with block, Bidirectional ventricular tachycardia, ventricular fibrillation) and death (3,5,10). In addition, there may be paresthesias, weakness, hypertonia and excessive salivation and altered sensorium (3,10). The postmortem appearance shows generalized hemorrhages and signs of gastrointestinal irritation (11).


Category (General Medicine)  |   Views (4101)  |  User Rating
Rate It


Browse Archive