Podophyllotoxin intoxication: toxic effect of Bajiaolian in herbal therapeutics.
Bajiaolian (Dysosma pleianthum), one species in the Mayapple family, has been widely used as a general remedy and for the treatment of snake bite, weakness, condyloma accuminata, lymphadenopathy and tumours in China for thousands of years. However, the textbooks of traditional Chinese medicine mention little about the toxicity of Bajiaolian. Within 1 year, the authors saw five people who manifested nausea, vomiting, diarrhoea, abdominal pain, thrombocytopenia, leucopenia, abnormal liver function tests, sensory ataxia, altered consciousness and persistant peripheral tingling or numbness after drinking infusions made with Bajiaolian. The herb was recommended by either traditional Chinese medical doctors or herbal pharmacies for postpartum recovery and treatment of a neck mass, hepatoma, lumbago and dysmenorrhoea. Podophyllotoxin is one of the main ingredients of the Bajiaolian root. The clinical manifestations observed in our patients were consistent with podophyllum intoxication. Podophyllotoxin intoxication usually results from the accidental ingestion or topical application of podophyllum resin. However, these cases of Bajiaolian intoxication were iatrogenic and results from 'therapeutic doses' of Bajiaolian cited in the textbooks of traditional Chinese medicine.
Department of Emergency Medicine, Veterans General Hospital, Taipei, Taiwan.
W F
WF
Kao
D Z
DZ
Hung
W J
WJ
Tsai
K P
KP
Lin
J F
JF
Deng
D000328:Adult; D002493:Central Nervous System Diseases / Q000139:chemically induced / Q000503:physiopathology; D004365:Drugs, Chinese Herbal / Q000009:adverse effects*; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010292:Paresthesia / Q000139:chemically induced / Q000503:physiopathology; D011034:Podophyllotoxin / Q000506:poisoning*
D004365:Drugs, Chinese Herbal; D011034:Podophyllotoxin