Display options
Cite
Maes KR, Depuydt P, Vermassen J, et al. Foxglove poisoning: diagnostic and therapeutic differences with medicinal digitalis glycosides overdose. Acta Clin Belg. 2020;1-7doi: 10.1080/17843286.2020.1773652.
Maes, K. R., Depuydt, P., Vermassen, J., De Paepe, P., Buylaert, W., & Lyphout, C. (2020). Foxglove poisoning: diagnostic and therapeutic differences with medicinal digitalis glycosides overdose. Acta clinica Belgica, 1-7. https://doi.org/10.1080/17843286.2020.1773652
Maes, Koen R, et al. "Foxglove poisoning: diagnostic and therapeutic differences with medicinal digitalis glycosides overdose." Acta clinica Belgica vol. (2020): 1-7. doi: https://doi.org/10.1080/17843286.2020.1773652
Maes KR, Depuydt P, Vermassen J, De Paepe P, Buylaert W, Lyphout C. Foxglove poisoning: diagnostic and therapeutic differences with medicinal digitalis glycosides overdose. Acta Clin Belg. 2020 Jun 04;1-7. doi: 10.1080/17843286.2020.1773652. Epub 2020 Jun 04. PMID: 32496148.
Copy Download .nbib Format: NLM
Share it on

Acta Clin Belg. 2020 Jun 04;1-7. doi: 10.1080/17843286.2020.1773652. Epub 2020 Jun 04.

Foxglove poisoning: diagnostic and therapeutic differences with medicinal digitalis glycosides overdose.

Acta clinica Belgica

Koen R Maes, Pieter Depuydt, Joris Vermassen, Peter De Paepe, Walter Buylaert, Cathelijne Lyphout

Affiliations

  1. Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium.
  2. Department of Intensive Care, Ghent University Hospital, Ghent, Belgium.
  3. Department of Emergency Medicine and Clinical Toxicology, Ghent University Hospital, Ghent, Belgium.

PMID: 32496148 DOI: 10.1080/17843286.2020.1773652

Abstract

We report a case of a 19-year-old woman who ingested Digitalis purpurea leaves as a suicide attempt. She developed gastro-intestinal symptoms, loss of colour vision, cardiac conduction disturbances as well as an elevated serum potassium. Treatment was initiated in analogy to medicinal digoxin poisoning by means of digoxin-specific Fab-fragments with a good effect. However during the further course we faced difficulties of prolonged intestinal absorption and inability to estimate the ingested dose or half-life of the vegetal cardiac glycoside compounds. To prevent further absorption and interrupt enterohepatic recycling, multi-dose activated charcoal was administered. Because of a relapse of cardiac conduction disturbances and hyperkalemia, two supplementary doses of Fab-fragments were given, up to a total dose of nineteen vials (one vial containing 40 mg). The important diagnostic and therapeutic differences of vegetal digitalis intoxication as compared to medicinal intoxication and the applicability of existing guidelines on medicinal digitalis intoxication in the light of these differences will be discussed here.

Keywords: Digitalis purpurea poisoning; digitoxicity; fab fragments; foxglove

Publication Types