digitoxin and Diarrhea

One day after drinking what she thought to be a tea made from borage leaves a 72-year-old woman developed nausea, vomiting and diarrhoea, later also flickering in her eyes and palpitations. She was in a good general state with a blood pressure of 120/75 mm Hg and an irregular heart rate of 52/min. Physical examination was otherwise unremarkable. She had not been on any medication.. The usual laboratory tests were normal. The electrocardiogram showed atrial fibrillation with a slow ventricular rate with pauses of up to 1.5s. intermittently type I and II 2 degrees AV block, and depressed concave ST segments. The level of digoxin was 3.93 ng/ml, that of digitoxin 133.5 ng/ml.. The patient's symptoms quickly improved under symptomatic treatment. Further questioning suggested that she had probably mistaken foxglove leaves for those of borage when picking them to make a brew.. If cardiac arrhythmias have occurred after intake of self-picked herbal leaves one should consider digitalis intoxication resulting from misidentification.

Topics: Acute Disease; Aged; Atrial Fibrillation; Bradycardia; Diarrhea; Digitalis; Female; Humans; Plant Poisoning; Plants, Medicinal; Plants, Toxic; Tea; Vomiting

Topics: Administration, Oral; Adolescent; Adult; Aged; Diarrhea; Digitoxin; Female; Humans; Intestinal Absorption; Male; Middle Aged; Radioimmunoassay; Time Factors

Topics: Animals; Arrhythmias, Cardiac; Breast; Diarrhea; Digitalis; Digitalis Glycosides; Dogs; Drug Hypersensitivity; Endocrine Glands; Eye Manifestations; Hyperkalemia; Hypertrophy; Neurologic Manifestations; Toxicology

Topics: Atrial Flutter; Diarrhea; Digitalis; Digitalis Glycosides; Humans