RESUMEN
BACKGROUND: Ecbalium elaterium is a plant endemic to the Mediterranean basin. Its roots and cucumber-shaped fruit have been used in folk medicine since antiquity. The alleged uses of the fruit juice are as a potent cathartic, analgesic, and antiinflammatory agent. Cucurbitacin B, a triterpene derivative is the active antiinflammatory principal. PATIENTS: We present a series of 13 patients who were exposed to the juice of Ecbalium elaterium in its natural form. In 3 patients, exposure was intranasal for the treatment of sinusitis or liver cirrhosis. In 3 other cases, children ingested the fruit unwittingly. In 6 patients, exposure was ocular and, in one, dermal. Within minutes of exposure, the patients exhibited irritation of mucous membranes at various degrees of severity manifested as edema of pharynx, dyspnea, drooling, dysphagia, vomiting, conjunctivitis, corneal edema, and erosion, depending on the route of the exposure. Recovery began within several to 24 hours after administration of oxygen, steroids, antihistamines, and beta-2-agonists. Ocular exposures responded to topical steroid and antibiotic eyedrops within a few days. The toddler with the dermal exposure remained asymptomatic. CONCLUSION: Exposure to the juice of Ecbalium elaterium, mainly in its undiluted form, may cause irritation of mucous membranes, supposedly of inflammatory nature. Patients exposed orally or intranasally should be closely followed for upper airway obstruction. Patients exposed ocularly should have their eyes promptly irrigated to prevent corneal and conjunctival injury.
Asunto(s)
Cucurbitaceae/envenenamiento , Cucurbitaceae/uso terapéutico , Fitoterapia , Adolescente , Adulto , Antiinflamatorios no Esteroideos/envenenamiento , Antiinflamatorios no Esteroideos/uso terapéutico , Niño , Preescolar , Conjuntivitis/inducido químicamente , Edema Corneal/inducido químicamente , Trastornos de Deglución/inducido químicamente , Disnea/inducido químicamente , Femenino , Humanos , Cirrosis Hepática/tratamiento farmacológico , Masculino , Membrana Mucosa/efectos de los fármacos , Membrana Mucosa/patología , Extractos Vegetales/envenenamiento , Extractos Vegetales/uso terapéutico , Intoxicación/terapia , Estudios Retrospectivos , Sinusitis/tratamiento farmacológico , Triterpenos/envenenamiento , Triterpenos/uso terapéutico , Vómitos/inducido químicamenteRESUMEN
Oral administration of lantana leaves (6 g/kg body weight) and isolated toxins (125 mg/kg body weight) to rabbits caused ictericity, anorexia and decrease in fecal output. There was increased size of the kidneys, and the livers were ochre-colored and fragile but there was no hepatomegaly. Histopathologically, lantana-intoxicated rabbits had swellings of hepatic cells, portal fibrosis, dilatation of bile canaliculi and biliary hyperplasia. Kidneys had proliferation of mesenchymal cells in glomerular tufts, degeneration of tubules, swelling of tubular epithelial cells and pyknosis of nuclei. The intoxicated animals had elevated levels of conjugated and unconjugated bilirubin in plasma, the major increase being in the conjugated form (suggestive of obstructive jaundice). There were marginal changes in the activities of acid phosphatase and glutamate oxaloacetate transaminase in the plasma.
Asunto(s)
Intoxicación por Plantas/veterinaria , Triterpenos/envenenamiento , Animales , Anorexia/inducido químicamente , Riñón/efectos de los fármacos , Hígado/efectos de los fármacos , Hígado/enzimología , Masculino , ConejosRESUMEN
Lantana poisoning in ruminants results from the ingestion of toxic varieties of the plant Lantana camara, which contain the triterpene acids lantadene A and lantadene B. Poisoning results in intrahepatic cholestasis and the consequences of the liver injury include jaundice, photosensitisation and ruminal stasis. The decreased ruminal motility causes toxic material to be retained in the rumen and continuous absorption of toxins from the rumen maintains the disease. Lantana poisoning can best be treated by preventing further absorption of toxins. This can be achieved by giving a large quantity of activated charcoal into the rumen together with a large volume of a multiple electrolyte solution to stimulate ruminal motility and rehydrate the animal. Treatment for photosensitive dermatitis should also be given.
Asunto(s)
Intoxicación por Plantas/veterinaria , Rumiantes , Animales , Bovinos , Cabras , Ácido Oleanólico/análogos & derivados , Ácido Oleanólico/envenenamiento , Intoxicación por Plantas/fisiopatología , Intoxicación por Plantas/terapia , Ovinos , Triterpenos/envenenamientoRESUMEN
Toxic Lantana camara taxa growing in Queensland all contain the triterpene acids lantadene A, reduced lantadene A and lantadene B. These when dosed as pure compounds orally to sheep were similarly toxic at 65 to 75, 42 to 80 and 200 to 300 mg/kg body weight respectively, causing jaundice, photosensitisation, kidney and liver lesions typical of natural and experimental lantana poisoning. Because of its comparative toxicity and abundance lantadene A is the most significant toxic principle in the plant. Reduced lantadene A because of its low concentration in the leaves (5% of lantadene A) and lantadene B because of its significantly lower toxicity are thus unlikely to be of much importance in the poisoning of ruminants following consumption of the plant. In addition, the structural features of both lantadene A and B molecules given to sheep by the oral route do not conform to the chemical structures previously reported to be required for liver damaging action of the verbenaceous triterpenes administered to rabbits by the intraperitoneal route.