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Year: 2011

Acute poisoning: analysis of clinical features and circumstances of exposure

Fuchs, J ; Rauber-Lüthy, C ; Kupferschmidt, H ; Kupper, J ; Kullak-Ublick, G A ; Ceschi, A

Abstract: INTRODUCTION: Human contact with potentially toxic , which may occur through abuse or by accident or attempted suicide, is frequent and sometimes results in clinically significant toxic- ity. OBJECTIVE: The aim of the present study was to identify which plants may lead to severe poisoning, and to define the clinical relevance of plant toxicity for humans in Switzerland. METHODS: Weanalyzed 42,193 cases of human plant exposure and 255 acute moderate, severe, and lethal poisonings, which were reported to the Swiss Toxicological Information Centre between January 1995 and December 2009. RE- SULTS: Plant contact was rarely responsible for serious poisonings. Lethal intoxications were extremely rare and were caused by plants with cardiotoxic (Taxus baccata) or mitosis-inhibiting (Colchicum au- tumnale) properties. CONCLUSIONS: Most often, plant contact was accidental and patients remained asymptomatic or developed mild symptoms, which fully resolved within a short time.

DOI: https://doi.org/10.3109/15563650.2011.597034

Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-58163 Journal Article Accepted Version

Originally published at: Fuchs, J; Rauber-Lüthy, C; Kupferschmidt, H; Kupper, J; Kullak-Ublick, G A; Ceschi, A (2011). Acute plant poisoning: analysis of clinical features and circumstances of exposure. Clinical Toxicology, 49(7):671- 680. DOI: https://doi.org/10.3109/15563650.2011.597034 *Manuscript Click here to view linked References

Acute Plant Poisoning: Clinical Features and 1 2 Circumstances of Exposure 3 4 5 6 7 Joan Fuchsa, Christine Rauber-Lüthya, Hugo Kupferschmidta, Jacqueline Kuppera,c, 8 9 Gerd A. Kullak-Ublickb and Alessandro Ceschia 10 11 12 13 14 15 16 (a) Swiss Toxicological Information Centre (STIC), Zurich, Switzerland 17 18 (b) Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, 19 20 Switzerland 21 22 23 (c) Institute of Veterinary Pharmacology and Toxicology, Vetsuisse Faculty, 24 University of Zurich, Switzerland 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 Corresponding author: 42 43 Alessandro Ceschi, MD 44 45 Head, Division of Science 46 47 Swiss Toxicological Information Centre 48 49 Freiestrasse 16 50 51 CH-8032 Zurich 52 53 Tel: +41-44-634-1034 54 55 Fax: +41-44-252-8833 56 57 e-mail: [email protected] 58 59 60 61 62 63 64 65

1 2 Abstract 3 4 Human contact with potentially toxic plants, which may occur in abuse or in an 5 6 accidental or suicidal setting, is frequent and sometimes results in clinically 7 8 significant toxicity. The aim of the present study was to identify which plants may lead 9 10 to severe poisoning, and to define the clinical relevance of plant toxicity for humans 11 12 in central . By means of a retrospective case-study design, we analysed 13 14 42’193 cases of human plant exposure and 255 acute moderate, severe, and lethal 15 poisonings, which were reported to the Swiss Toxicological Information Centre 16 17 between January 1995 and December 2009. Plant contact was rarely responsible for 18 19 serious poisonings. Lethal intoxications were extremely rare and were caused by 20 21 plants with cardiotoxic (Taxus baccata) or mitose inhibiting (Colchicum autumnale) 22 23 properties. Most often, plant contact was accidental and patients remained 24 25 asymptomatic or developed mild symptoms, which fully resolved within a short time. 26 27 28 29 30 31 32 Keywords: Plants, toxicity, poisoning, accidental, abuse, suicidal, severe, lethal 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50