Een giftige lente-smoothie van wilde kruiden

Accidentele intoxicatie met vingerhoedskruid (Digitalis purpurea)
Casuïstiek
17-11-2020
Jurjen S. Kingma, Irene M. Frenay, Arend Jan Meinders, Vincent F. van Dijk en Ankie M. Harmsze

A poisonous spring smoothie with wild herbs: accidental intoxication with foxglove (Digitalis purpurea)

Background

At a time when self-sufficiency and health are becoming increasingly important in society, the chances of intoxications with wild plants are increasing. Foxglove contains poisonous cardiac glycosides such as digoxin, digitoxin and gitoxin. The levels vary greatly and depend on the season and the location of the plants. The "non-digoxin" cardiac glycosides show a limited cross-reaction with the digoxin assay. This means that a low or therapeutic digoxin level does not rule out a severe foxglove intoxication. Due to the long half-life of the different cardiac glycosides, toxic symptoms can be persistent.

Case description

A 43-year-old woman arrived at the Emergency Department with persistent vomiting and specific ECG-abnormalities. The day before, she drunk a smoothie made from wild plants picked in the woods. Patient appeared to have mistaken foxglove for common sorrel.

Conclusion

In case of persistent gastrointestinal complaints with specific ECG abnormalities after ingestion of plant material, clinicians should be aware of a foxglove intoxication.

Conflict of interest and financial support: none declared.