دورية أكاديمية
Recurrent malignant ventricular arrhythmias and paresthesia-a mystery revealed as aconitine poisoning: a case report.
| العنوان: | Recurrent malignant ventricular arrhythmias and paresthesia-a mystery revealed as aconitine poisoning: a case report. |
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| المؤلفون: | Mjølstad OC; Clinic of Cardiology, St. Olav-Trondheim University Hospital, Torgarden, P.O box 3250, 7006, Trondheim, Norway. ole.christian.mjolstad@stolav.no.; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway. ole.christian.mjolstad@stolav.no., Radtke M; Department of Nephrology, St. Olav-Trondheim University Hospital, Trondheim, Norway.; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway., Brodtkorb E; Department of Neurology and Clinical Neurophysiology, St. Olav-Trondheim University Hospital, Trondheim, Norway.; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway., Edvardsen F; Department of Clinical Pharmacology, St. Olav-Trondheim University Hospital, Trondheim, Norway., Brede WR; Department of Clinical Pharmacology, St. Olav-Trondheim University Hospital, Trondheim, Norway., Aamo TO; Department of Clinical Pharmacology, St. Olav-Trondheim University Hospital, Trondheim, Norway., Jacobsen D; Department of Acute Medicine, Oslo University Hospital Ulleval, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; National Poisons Information Centre, Oslo, Norway., Stokke MK; Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway.; KG Jebsen Centre for Cardiac Research, University of Oslo, Oslo, Norway.; Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway., Helland A; Department of Clinical Pharmacology, St. Olav-Trondheim University Hospital, Trondheim, Norway.; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway. |
| المصدر: | Journal of medical case reports [J Med Case Rep] 2023 Dec 21; Vol. 17 (1), pp. 554. Date of Electronic Publication: 2023 Dec 21. |
| نوع المنشور: | Case Reports; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 101293382 Publication Model: Electronic Cited Medium: Internet ISSN: 1752-1947 (Electronic) Linking ISSN: 17521947 NLM ISO Abbreviation: J Med Case Rep Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [London] : BioMed Central, [2007- |
| مواضيع طبية MeSH: | Aconitine*/poisoning , Arrhythmias, Cardiac*/chemically induced , Arrhythmias, Cardiac*/therapy , Heart Arrest*/chemically induced , Heart Arrest*/therapy , Paresthesia*, Humans ; Male ; Middle Aged ; Heart ; White People |
| مستخلص: | Background: We report a case of a clinical challenge lasting for 12 months, with severe and unresolved clinical features involving several medical disciplines. Case Presentation: A 53-year-old Caucasian male, who had been previously healthy apart from a moderate renal impairment, was hospitalized 12 times during a 1-year period for a recurrent complex of neurological, cardiovascular, and gastrointestinal symptoms and signs, without any apparent etiology. On two occasions, he suffered a cardiac arrest and was successfully resuscitated. Following the first cardiac arrest, a cardiac defibrillator was inserted. During the 12th admission to our hospital, aconitine poisoning was suspected after a comprehensive multidisciplinary evaluation and confirmed by serum and urine analyses. Later, aconitine was also detected in a hair segment, indicating exposure within the symptomatic period. After the diagnosis was made, no further episodes occurred. His cardiac defibrillator was later removed, and he returned to work. A former diagnosis of epilepsy was also abandoned. Criminal intent was suspected, and his wife was sentenced to 11 years in prison for attempted murder. To make standardized assessments of the probability for aconitine poisoning as the cause of the eleven prior admissions, an "aconitine score" was established. The score is based on neurological, cardiovascular, gastrointestinal, and other clinical features reported in the literature. We also make a case for the use of hair analysis to confirm suspected poisoning cases evaluated after the resolution of clinical features. Conclusion: This report illustrates the medical challenge raised by cases of covert poisoning. In patients presenting with symptoms and signs from several organ systems without apparent cause, poisoning should always be suspected. To solve such cases, insight into the effects of specific toxic agents is needed. We present an "aconitine score" that may be useful in cases of suspected aconitine poisoning. (© 2023. The Author(s).) |
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| فهرسة مساهمة: | Keywords: Aconitine; Arrhythmias; Cardiac arrest; Diagnostic challenges; Epilepsy; Homicidal poisoning; Poisoning; Seizures |
| المشرفين على المادة: | X8YN71D5WC (Aconitine) |
| تواريخ الأحداث: | Date Created: 20231222 Date Completed: 20231225 Latest Revision: 20240226 |
| رمز التحديث: | 20240226 |
| مُعرف محوري في PubMed: | PMC10740282 |
| DOI: | 10.1186/s13256-023-04304-2 |
| PMID: | 38129927 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1752-1947 |
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| DOI: | 10.1186/s13256-023-04304-2 |