Zeitschrift für Kardiologie

, Volume 94, Issue 12, pp 817–823

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
CASE REPORT

Summary

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.

Key words

Intoxication child oleander cardiac glycosides digoxin-specific Fab antibody fragments 

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

Zusammenfassung

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.

Schlüsselwörter

Intoxikation Kind Oleander Herzglykoside Digitalis-Antidot 

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Copyright information

© Steinkopff-Verlag 2005

Authors and Affiliations

  1. 1.The Prince Charles HospitalChermside 4065Australien
  2. 2.Royal Children’s HospitalHerston 4029Australien

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