Clinical review of grayanotoxin/mad honey poisoning past and present

GÜNDÜZ A., TÜREDİ S., RUSSELL R. M., AYAZ F. A.

CLINICAL TOXICOLOGY, cilt.46, sa.5, ss.437-442, 2008 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 46 Sayı: 5
  • Basım Tarihi: 2008
  • Doi Numarası: 10.1080/15563650701666306
  • Dergi Adı: CLINICAL TOXICOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.437-442
  • Anahtar Kelimeler: grayanotoxin, Rhododendron, mad honey, andromedotoxin, MAD HONEY, RHODODENDRON, BRADYCARDIA, TURKEY, RATS, MICE
  • Karadeniz Teknik Üniversitesi Adresli: Evet

Özet

Grayanotoxin is a naturally occurring sodium channel toxin which enters the human food supply by honey made from the pollen and nectar of the plant family Ericaceae in which rhododendron is a genus. Grayanotoxin/mad honey poisoning is a little known, but well studied, cholinergic toxidrome resulting in incapacitating and, sometimes, life-threatening bradycardia, hypotension, and altered mental status. Complete heart blocks occur in a significant fraction of patients. Asystole has been reported. Treatment with saline infusion and atropine alone is almost always successful. A pooled analysis of the dysrhythmias occurring in 69 patients from 11 different studies and reports is presented. The pathophysiology, signs, symptoms, clinical course, and treatment of grayanotoxin/mad honey poisoning are discussed. In the nineteenth century grayanotoxin/mad honey poisoning was reported in Europe and North America. Currently, documented poisoning from locally produced honey in Europe or North America would be reportable. Possible reasons for this epidemiologic change are discussed.