title: An unusual case of Butcher's Broom precipitating diabetic ketoacidosis.
abstract: BACKGROUND
  Herbal medicines are readily available and commonly perceived to be relatively harmless. Butcher's Broom is used in various medicinal preparations and contains substances having α-adrenergic-stimulating properties.
  
  
  OBJECTIVE
  Our aim was to report a case of toxicity associated with Butcher's Broom in a diabetic patient.
  
  
  METHODS
  A 39-year-old woman developed diabetic ketoacidosis 5 days after beginning therapy with Butcher's Broom for mild ankle swelling. Her diabetic ketoacidosis was complicated by hyperkalemia and acidosis with a pH of 7.02. After management with intravenous fluid, insulin, and calcium gluconate, her condition stabilized and she was discharged several days later.
  
  
  CONCLUSIONS
  This case represents a small but potentially serious public health concern in a diabetic woman taking Butcher's Broom.
authors.affiliation: Department of Cardiology, Northampton General Hospital, UK.
authors.forename: Praveen P
authors.initials: PP
authors.lastname: Sadarmin
authors.forename: Jonathan
authors.initials: J
authors.lastname: Timperley
mesh_terms: D000328:Adult; D048909:Diabetes Complications / Q000139:chemically induced*; D004487:Edema / Q000188:drug therapy*; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced / Q000188:drug therapy; D007662:Ketosis / Q000139:chemically induced* / Q000188:drug therapy; D008517:Phytotherapy; D028321:Plant Preparations / Q000009:adverse effects; D031443:Ruscus / Q000009:adverse effects*
chemical_list: D028321:Plant Preparations
keywords: Butcher's Broom; diabetes mellitus; diabetic ketoacidosis; herbal medicines