Treatment of toad venom poisoning with digoxin-specific Fab fragments.
Toxicity from toad venom poisoning is similar to digoxin toxicity and carries a high mortality rate. We report on six previously healthy men who developed vomiting and bradycardia after ingesting a purported topical aphrodisiac. Each patient had positive apparent digoxin levels and the first four patients died of cardiac dysrhythmias. The last two patients recovered following treatment with digoxin Fab fragments. We analyzed samples of the purported aphrodisiac and found that it was identical to Chan Su, a Chinese medication made from toad venom. To our knowledge, this is the first reported use of digoxin Fab fragments to treat toad venom poisoning.
New York City Poison Control Center, New York, USA.
J R
JR
Brubacher
P R
PR
Ravikumar
T
T
Bania
M B
MB
Heller
R S
RS
Hoffman
D000293:Adolescent; D000328:Adult; D000664:Amphibian Venoms / Q000032:analysis / Q000506:poisoning*; D000818:Animals; D001046:Aphrodisiacs / Q000032:analysis / Q000506:poisoning*; D001919:Bradycardia / Q000139:chemically induced; D002018:Bufanolides / Q000032:analysis / Q000506:poisoning; D002025:Bufonidae; D002027:Bufotenin / Q000032:analysis / Q000506:poisoning; D004077:Digoxin / Q000276:immunology* / Q000506:poisoning; D017809:Fatal Outcome; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D008297:Male; D008419:Materia Medica / Q000032:analysis / Q000506:poisoning*; D014693:Ventricular Fibrillation / Q000139:chemically induced; D014839:Vomiting / Q000139:chemically induced
D000664:Amphibian Venoms; D001046:Aphrodisiacs; D002018:Bufanolides; D007140:Immunoglobulin Fab Fragments; D008419:Materia Medica; C050199:digoxin antibodies Fab fragments; D002027:Bufotenin; D004077:Digoxin; C063451:cinobufotalin; C002471:cinobufagin; C022777:bufalin