title: Mad honey poisoning.
abstract: Grayanotoxin intoxication, which is mostly seen in the eastern Black Sea region of Turkey, stems from the "mad honey" made by bees from the rhododendron plant flowers. In low doses, this causes dizziness, hypotension, and bradycardia, and in high doses, impaired consciousness, seizures, and atrioventricular block (AVB). This case study was designed as a series of cases of patients (6 women, 2 men) aged between 35 and 75 years. All of the patients' physical examinations revealed hypotension; 4 patients had sinus bradycardia, 3 had nodal rhythm, and 1 had complete AVB. In all patients, except for the patient with AVB, heart rate and blood pressure returned to normal limits within 2 to 6 hours. Two patients were monitored in the coronary intensive care unit. Of these 2, 1 was discharged on the second day. The other was fitted with a temporary pacemaker and was discharged on the third day. All the other patients were kept in for a 6-hour observation period and were then discharged from the ED. To date, 58 such cases have been reported, but we saw 8 patients within 2005. It is commonly seen in the east of the Black Sea region, although cases may occur from all over the eastern Black Sea region of Turkey. So far, no cases of death have been reported, although grayanotoxin causes adverse effects on the cardiovascular and respiratory systems and is therefore of considerable importance.
authors.affiliation: Department of Emergency Medicine, Karadeniz Technical University Faculty of Medicine, 61080 Trabzon, Turkey. gunduzkadir@hotmail.com
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Gunduz
authors.forename: Suleyman
authors.initials: S
authors.lastname: Turedi
authors.forename: Hukum
authors.initials: H
authors.lastname: Uzun
authors.forename: Murat
authors.initials: M
authors.lastname: Topbas
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000506:poisoning; D001919:Bradycardia / Q000139:chemically induced / Q000628:therapy; D004224:Diterpenes / Q000506:poisoning; D005260:Female; D005517:Foodborne Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D006722:Honey / Q000506:poisoning*; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000628:therapy; D008297:Male; D008875:Middle Aged; D029793:Rhododendron; D014421:Turkey
chemical_list: D000959:Antihypertensive Agents; D004224:Diterpenes; C001311:grayanotoxin I