Clinical features and management of herb-induced aconitine poisoning.
OBJECTIVE
We define the potential sources, clinical manifestations, and treatment of aconitine poisoning.


METHODS
The database of the National Poison Center in Taiwan was retrospectively searched for the diagnosis of aconitine poisoning for 1990 to 1999. The reasons for taking the aconite roots, the clinical features, management, and possible predisposing factors were noted.


RESULTS
A total of 17 cases occurred and consisted of 9 men and 8 women aged 30 to 70 years. Thirteen patients ingested aconite roots as treatment for rheumatism and wounds. Two patients volunteered to test the effects of aconite roots in a drug study. Two patients accidentally ingested the aconite roots. After a latent period of 10 to 90 minutes, patients developed a combination of neurologic (n=17), cardiovascular (n=14), gastrointestinal (n=9), and other (n=5) features typical of aconitine poisoning. Four patients developed ventricular tachycardia. All patients received supportive treatment. Patients with ventricular tachycardia were also treated with charcoal hemoperfusion. All patients made a complete recovery.


CONCLUSIONS
Life-threatening ventricular tachycardia can occur after the consumption of aconite roots. The risk is higher with inadequately processed aconite roots, large doses, or tincture preparations. With increasing popularity of herbal medicines, herb-induced aconitine poisoning may also be seen in Western countries.
Lin
Chih-Chuan
CC
Emergency Department, Chang Gung Memorial Hospital, Taipei, Taiwan. bearuncle@yahoo.com
Chan
Thomas Y K
TY
Deng
Jou-Fang
JF
D000157:Aconitine / Q000506:poisoning*; D031841:Aconitum; D000328:Adult; D000368:Aged; D001919:Bradycardia / Q000139:chemically induced; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000188:drug therapy; D017180:Tachycardia, Ventricular / Q000139:chemically induced*; D018879:Ventricular Premature Complexes / Q000139:chemically induced; D014947:Wounds and Injuries / Q000188:drug therapy
D000157:Aconitine