Plasma level of atropine after accidental ingestion ofAtropa belladonna

Emerging Issues on Tropane Alkaloid Contamination of Food in Europe

The occurrence of tropane alkaloids (TAs), toxic plant metabolites, in food in Europe was studied to identify those TAs in food most relevant for human health. Information was extracted from the literature and the 2016 study from the European Food Safety Authority. Calystegines were identified as being inherent TAs in foods common in Europe, such as Solanum tuberosum (potato), S. melongena (eggplant, aubergine), Capsicum annuum (bell pepper) and Brassica oleracea (broccoli, Brussels sprouts). In addition, some low-molecular-weight tropanes and Convolvulaceae-type TAs were found inherent to bell pepper. On the other hand, atropine, scopolamine, convolvine, pseudotropine and tropine were identified as emerging TAs resulting from the presence of associated weeds in food. The most relevant food products in this respect are unprocessed and processed cereal-based foods for infants, young children or adults, dry (herbal) teas and canned or frozen vegetables. Overall, the occurrence data on both inherent as well as on associated TAs in foods are still scarce, highlighting the need for monitoring data. It also indicates the urge for food safety authorities to work with farmers, plant breeders and food business operators to prevent the spreading of invasive weeds and to increase awareness.

A Poisoning Outbreak Caused by Anisodus tanguticus - Maqin County, Qinghai Province, China, July 2021

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?

Anisodus tanguticus belongs to the Solanaceae family. The plant is toxic due to the tropane alkaloids it contains and can cause poisoning when it is ingested or used inappropriately.

WHAT IS ADDED BY THIS REPORT?

A poisoning outbreak involved 10 patients, and one death was caused by Anisodus tanguticus. The etiological association of plant exposure and poisoning was confirmed with evidence from an epidemiological investigation, clinical manifestations, plant identification and a toxin analysis.

WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?

The risk of poisoning caused by mistakenly collecting and ingesting tropane alkaloid-containing plants should be highlighted, and public health practitioners should be on alert.

Anticholinergic syndrome after atropine overdose in a supposedly homeopathic solution: a case report

BACKGROUND

A 53-year-old male with no pre-existing conditions and no permanent medication presented to our emergency department with an anticholinergic syndrome including confusion, anxiety, ataxia and dysarthria after ingestion of a homeopathic solution containing Atropa belladonna extract supposedly in a D4 dilution.

METHODS

Atropine sulphate was quantitatively analysed in serum and the homeopathic preparation via liquid chromatography/mass spectrometry.

RESULTS

Analysis revealed concentrations of approximately 3 mg/mL atropine sulphate in the homeopathic solution and a serum level of 5.7 ng/mL (±1.4) in the patient's blood proving a 600-fold overdose of atropine due to a production error of the homeopathic dilution. The patient was observed and recovered without further intervention.

CONCLUSION

Rare but possibly dangerous manufacturing errors should be considered when faced with symptoms occurring after ingestion of homeopathic or holistic remedies.

Sagas of the Solanaceae: Speculative ethnobotanical perspectives on the Norse berserkers

ETHNOPHARMACOLOGICAL RELEVANCE

The Norse berserkers were wild warriors of Scandinavia known to enter a trance-like state that allowed them to fight with increased strength and a rage that granted them immunity to many forms of harm in battle. Though many theories have been advanced as to the cause of this state, the most widely believed is that the intoxicating mushroom Amanita muscaria was used.

AIM OF THE STUDY

The following article underlines the issues with this theory and provides an alternate intoxicant that fits with the reports of berserker behaviour much better: Hyoscyamus niger.

MATERIALS AND METHODS

Literature from a variety of disciplines pertaining to history, toxicology, pharmacology, and botany was compiled to frame and support the argument.

RESULTS

H. niger proved to be a more likely intoxicant used to induce the berserker rage state.

CONCLUSIONS

With its anticholinergic tropane alkaloids and symptom profile, H. niger is a much more likely cause of the berserker state than A muscaria. Though there is not enough archaeological and historical evidence to prove or disprove this theory, it provides a novel explanation that is at present the most viable means of understanding the berserkers' trance.

Accidental overdose in the deep shade of night: a warning on the assumed safety of 'natural substances'

There is an increasing use of herbal remedies and medicines, with a commonly held belief that natural substances are safe. We present the case of a 50-year-old woman who was a trained herbalist and had purchased an 'Atropa belladonna (deadly nightshade) preparation'. Attempting to combat her insomnia, late one evening she deliberately ingested a small portion of this, approximately 50 mL. Unintentionally, this was equivalent to a very large (15 mg) dose of atropine and she presented in an acute anticholinergic syndrome (confused, tachycardic and hypertensive) to our accident and emergency department. She received supportive management in our intensive treatment unit including mechanical ventilation. Fortunately, there were no long-term sequelae from this episode. However, this dramatic clinical presentation does highlight the potential dangers posed by herbal remedies. Furthermore, this case provides clinicians with an important insight into potentially dangerous products available legally within the UK. To help clinicians' understanding of this our discussion explains the manufacture and 'dosing' of the A. belladonna preparation.

[Severe atropine poisoning mimicking acute stroke]

INTRODUCTION

Atropine is a strong antagonist of muscarinic receptors widely used in various diseases because of its anticholinergic action.

CASE-REPORT

We report here a case of accidental poisoning due to ingestion of atropine eyes drops that caused severe neurologic disorders mimicking an acute stroke. Correct diagnosis was finally made by detecting atropine in the cerebrospinal fluid of the patient.

CONCLUSIONS

Atropinic poisoning can induce misleading neuropsychiatric disorders mimicking stroke. Therefore, this diagnosis should be considered in patients presenting an unexplained encephalopathy with anticholinergic manifestations, especially when bilateral mydriasis occurs.