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Successful treatment of oleander intoxication (cardiac glycosides) with digoxin-specific Fab antibody fragments in a 7-year-old child

Case report and review of literature

Erfolgreiche Therapie einer schweren Oleander-Vergiftung (Herzglykosid) mit Digitalis-Antidot bei einem 7-jährigen Kind—Fallbericht mit Literaturübersicht

  • CASE REPORT
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Zusammenfassung

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Ein 7-jähriges Mädchen erkrankte ca. sechs Stunden nach Einnahme eines Oleandersamens (Tropischer Oleander=Thevetia peruviana) mit schweren Symptomen einer Digitalis-Intoxikation wie starkes Erbrechen, Farbensehen und AV-Block Grad III. Therapieversuche mit Phenytoin und Isoprenalin-Infusion lösten intermittierende supraventrikuläre und ventrikulären Tachykardien aus. Die intravenöse Gabe von insgesamt 2×190 mg Digitalis-Antidot führte innerhalb von 2 Stunden zur Aufhebung des AV-Blockes und der klinischen Symptome.

Schlussfolgerung

Digitalis-Antidot ist sicher und nebenwirkungsfrei nach Oleander-Intoxikation bei einem sonst gesunden Kind anzuwenden.

Summary

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A 7-year-old girl presented six hours after ingestion of a yellow oleander seed (Thevetia peruviana) with severe emesis, change in colour vision and complete heart block. Initial treatment with phenytoin and isoprenalin infusion led to intermittent supraventricular and ventricular tachycardia. The patient was then treated with two intravenous doses of 190 mg of digoxin-specific Fab antibody fragments (Digibind®). Subsequently the patient’s rhythm reverted to sinus rhythm and the symptoms resolved within 2 hours.

Conclusion

administration of digoxin-specific Fab antibody fragments in an otherwise healthy child after oleander intoxication is safe and without adverse reactions.

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Author information

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Authors and Affiliations

  1. The Prince Charles Hospital, Rode Road, Chermside 4065, Australien

    C. Camphausen &  N. A. Haas

  2. Royal Children’s Hospital, Herston Road, Herston 4029, Australien

    A. C. Mattke

Authors
  1. C. Camphausen
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  2. N. A. Haas
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  3. A. C. Mattke
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Correspondence to C. Camphausen.

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Camphausen, C., Haas, N.A. & Mattke, A.C. Successful treatment of oleander intoxication (cardiac glycosides) with digoxin-specific Fab antibody fragments in a 7-year-old child. ZS Kardiologie 94, 817–823 (2005). https://doi.org/10.1007/s00392-005-0293-3

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  • DOI: https://doi.org/10.1007/s00392-005-0293-3

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