title: GC/MS identification of toxic pyrrolizidine alkaloids in traditional remedies given to two sets of twins.
abstract: Neo- and perinatal mortality is high in most of Africa. Twins are at particular risk of perinatal mortality. The contribution of traditional remedies is seldom addressed. The case histories of two sets of twins who were treated with traditional remedies are described. The herbal remedies were analysed using gas chromatography-mass spectrometry. In one family, both siblings survived, albeit with hepatic damage. In the other family, one twin died within 24 h and the second one month after admission with a diagnosis of veno-occlusive liver disease (VOD). In both cases, the presence of the toxic pyrrolizidine alkaloid retrorsine, which is known to lead to VOD, was identified. Health-care workers should be aware of the possibility of traditional medicine administration as a cause of illness, specifically in twin births.
authors.affiliation: Department of Chemical Pathology, University of the Witwatersrand Medical School, 7 York Rd., Parktown 2193, Johannesburg, South Africa.
authors.forename: Johan
authors.initials: J
authors.lastname: Conradie
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stewart
authors.forename: Vanessa
authors.initials: V
authors.lastname: Steenkamp
mesh_terms: D004200:Diseases in Twins / Q000209:etiology* / Q000401:mortality; D017809:Fatal Outcome; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods; D006504:Hepatic Veno-Occlusive Disease / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D016488:Medicine, African Traditional; D011041:Poisoning / Q000401:mortality; D011763:Pyrrolizidine Alkaloids / Q000506:poisoning*
chemical_list: D011763:Pyrrolizidine Alkaloids; C003300:retrorsine