Suicide tree poisoning

Authors

  • Shivaraja A. Department of Paediatrics, Sri Devraj Urs Medical College, Kolar, Karnataka, India
  • Shruti Appaji Department of Paediatrics, Sri Devraj Urs Medical College, Kolar, Karnataka, India
  • Sudha Reddy V. R. Department of Paediatrics, Sri Devraj Urs Medical College, Kolar, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20182591

Keywords:

Cardiotoxic, Yellow oleander

Abstract

Poisoning accounts to 0.33-7.6% paediatric emergency admissions, which are accidental or unintentional. Yellow oleander, an ornamental plant with a scientific name “Thevetia peruviana”. All the parts of the tree are poisonous hence, known as “Suicide Tree”. Trees are easily accessible and swallowing of seeds which are the most toxic, is the preferred mode of intentional poisoning in South India. Ingestion of one seed is equivalent to 100 digoxin tablets. The phytotoxins of the plant can cause local gastric irritation and severe cardiotoxic manifested as arrhythmias, conduction defects which if left untreated is fatal. Management includes gastric decontamination, specific antidotes anti-digoxin Fab and Fructose 1,6 diphosphate administration, cardioversion and cardiovascular supportive care. Here, authors report an adolescent female presenting with sinus bradycardia following intentional consumption of the yellow oleander seeds.

References

Parthasarathy A. IAP Textbook of Pediatrics. 5th ed. Gwalior: Jaypee Brothers Medical Publishers Ltd, 2013. Print.

Thevetiaperuviana (Pers.) K. Schum. India Biodiversity Portal. (cited 15 April 2017). Available at http://indiabiodiversity.org/species/show/32806

Eddleston M, Ariaratnam CA, Sjöström L, Jayalath S, Rajakanthan K, Rajapakse S, et al. Acute yellow oleander (Thevetia peruviana) poisoning: cardiac arrhythmias, electrolyte disturbances, and serum cardiac glycoside concentrations on presentation to hospital. Heart. 2000;83(3):301-6.

Kant S, Layland F, Rajniti P, Shivani S. Poisoning in Children. 4th ed. New Delhi: Jaypee Brothers Pvt. Ltd.; 2013.

Amrita P, Krishnaveni K, Neha K, Shanmugasundaram R, Sambathkumar R. A review of management of common oleander and yellow oleander poisoning. World J Pharam Pharmaceut Sci. 2016;5(12):493-503.

Rajapakse S. Management of yellow oleander poisoning. Clin Toxicol. 2009;47(3):206-12.

Mundkur S, Aroor S, Kumar S, Kashyap H. Yellow Oleander poisoning in children -a report of two cases. Pediatric Oncall. 2014;11(4).

Khan I, Kant C, Sanwaria A, Meena L. Acute cardiac toxicity of Nerium oleander/indicum poisoning (Kaner) poisoning. Heart Views. 2010;11(3):115.

Fentanes E. Eating seeds from the ‘be still’tree, yet having lucky nut poisoning: a case of acute yellow oleander poisoning. Br Med J Case Reports. 2014;2014:bcr2013200392.

Bandara V, Weinstein SA, White J, Eddleston M. A review of the natural history, toxinology, diagnosis and clinical management of Nerium oleander (common oleander) and Thevetia peruviana (yellow oleander) poisoning. Toxicon. 2010;56(3):273-81.

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Published

2018-06-22

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Section

Case Reports