Acute medicine & surgery · 2025
Jesaconitine monitoring in a case of severe aconitum poisoning with torsade de pointes treated via extracorporeal membrane oxygenation.
СтатьяНазвание и аннотация: Перевод в очереди
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Tomita Yoshitaka, Suzuki Keisuke, Kaizaki-Mitsumoto Asuka, Hattori-Usami Natsumi, Numazawa Satoshi, Kikuchi Kazuki, Inoue Gen, Miyamoto Kazuyuki, Yagi Masaharu, Dohi Kenji
Аннотация
BACKGROUND: Aconitum poisoning can cause severe arrhythmias. We report, for the first time, the detailed blood and urine concentrations of four aconitine alkaloids in a male patient in his 20s who ingested aconite roots with suicidal intent.
CASE PRESENTATION: The patient developed refractory torsade de pointes (TdP) and required veno-arterial extracorporeal membrane oxygenation. His TdP resolved 7 h after arrival, with sinus rhythm returning within 12 h. The patient was discharged 6 days later. Subsequent measurements of the four alkaloids over time showed that jesaconitine had the highest serum concentration, with the patient's sinus rhythm returning when the jesaconitine concentration was less than 1 ng/mL.
CONCLUSION: This report provides valuable insights into the disposition of aconitine alkaloids during severe intoxication. The changes in jesaconitine concentrations over time correlate with clinical symptoms, suggesting that these levels could guide treatment decisions in patients with severe Aconitum poisoning.
CASE PRESENTATION: The patient developed refractory torsade de pointes (TdP) and required veno-arterial extracorporeal membrane oxygenation. His TdP resolved 7 h after arrival, with sinus rhythm returning within 12 h. The patient was discharged 6 days later. Subsequent measurements of the four alkaloids over time showed that jesaconitine had the highest serum concentration, with the patient's sinus rhythm returning when the jesaconitine concentration was less than 1 ng/mL.
CONCLUSION: This report provides valuable insights into the disposition of aconitine alkaloids during severe intoxication. The changes in jesaconitine concentrations over time correlate with clinical symptoms, suggesting that these levels could guide treatment decisions in patients with severe Aconitum poisoning.