Acute Erycibe henryi Prain ("Ting Kung Teng") poisoning.
Erycibe henryi Prain ("Ting Kung Teng"), a species of Convolvulaceae, has been used in Chinese medicine to relieve pain involving the musculoskeletal system, such as arthritis, sciatica, and traumatic tissue swelling. E. henryi can be mistaken for another herbal plant, Tripterygium wilfordii Hook F, used to treat gouty arthritis. We report here three cases of E. henryi poisoning. All three cases presented with vomiting, diarrhea, salivation, diaphoresis, lacrimation, and rhinorrhea; two patients also had miosis, hypothermia, bradycardia, hypotension, and ventricular tachyarrhythmias. Laboratory abnormalities included leucocytosis, hyperglycemia, hyperamylasemia, hypocalcemia, and transiently elevated liver enzymes, creatinine and creatinine phosphokinase. The active constituents of E. henryi include several tropane alkaloids, which exhibit cholinergic activities. Gastrointestinal disturbances and ventricular tachyarrhythmias may occur with ingestion of either E. henryi or T. wilfordii, but the cholinergic symptoms can help to differentiate them.
Department of Emergency Medicine, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taiwan.
Hsien-Hao
HH
Huang
David Hung-Tsang
DH
Yen
Ming-Ling
ML
Wu
Jou-Fang
JF
Deng
Chun-I
CI
Huang
Chen-Hsen
CH
Lee
D000470:Alkaloids / Q000506:poisoning*; D027722:Convolvulaceae / Q000737:chemistry / Q000506:poisoning*; D004365:Drugs, Chinese Herbal / Q000506:poisoning*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010275:Parasympathetic Nervous System / Q000187:drug effects / Q000503:physiopathology; D010936:Plant Extracts / Q000506:poisoning; D011041:Poisoning / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D013577:Syndrome; D017180:Tachycardia, Ventricular / Q000139:chemically induced / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome
D000470:Alkaloids; D004365:Drugs, Chinese Herbal; D010936:Plant Extracts