Anticholinergic Syndrome Due to 'Devil's Herb'
Anticholinergic Syndrome Due to 'Devil's Herb'
We describe a case of Mandragora autumnalis poisoning which occurred in a 72-year-old female patient who had eaten the venenous M. Autumnalis, picked near her home, mistaking it for the edible Borago Officinalis. M. Autumnalis is a solanaceous plant, common in the Sicilian countryside, which contains a variable concentration of solanum alkaloids, causing gastrointestinal irritation, and tropane alkaloids, with anticholinergic properties. Unluckily, M. Autumnalis is often mistaken for the edible B. Officinalis, likewise widespread in Sicilian countryside. The diagnosis of Mandragora poisoning was made on the basis of clinical symptoms and signs of anticholinergic syndrome associated with a history of vegetable meal of uncontrolled origin, moreover analysing the vegetable obtained from gastric lavage. Decontamination and symptomatic treatment were useful in our patient to control acute poisoning.
Anticholinergic syndrome due to the adverse or toxic effects of several drugs is not an infrequent occurrence in the emergency department, and a differential diagnosis must be made. Causative agents such as drugs (tricyclic antidepressants, antihistamines, antiparkinsonism drug overdose), adverse effects from the ophthalmic use of atropine or scopolamine plasters and sympathomimetic syndrome due to cocaine, amphetamines or other drugs should be considered. Less frequently, agents, such as some types of vegetables, should be keep in mind to avoid medical mistakes. Only an accurate history and physical examination should lead to identification of the causal agent, allowing correct patient assessment and treatment.
Mandragora Autumnalis is a solanaceous plant that grows wild in the Sicilian countryside. It is an annual herb with oblong ovate leaves and blue violet flowers, which if eaten is to able to provoke an anticholinergic syndrome, and it must not be mistaken for 'mandrake' or American Mandragora.
Because of the 'human body' shape of its root and its narcotic and poisonous effects, from ancient times this plant, also known as 'Devil's herb', was believed to be an aphrodisiac and to have magic and medical properties. In 1518, Niccolò Machiavelli wrote the famous Italian tale 'Mandragola', underlining the 'medical' use of a Mandragora potion for infertility treating.
We report a case of anticholinergic syndrome due to unintentional assumption of Mandragora with clinical effects of its alkaloids.
We describe a case of Mandragora autumnalis poisoning which occurred in a 72-year-old female patient who had eaten the venenous M. Autumnalis, picked near her home, mistaking it for the edible Borago Officinalis. M. Autumnalis is a solanaceous plant, common in the Sicilian countryside, which contains a variable concentration of solanum alkaloids, causing gastrointestinal irritation, and tropane alkaloids, with anticholinergic properties. Unluckily, M. Autumnalis is often mistaken for the edible B. Officinalis, likewise widespread in Sicilian countryside. The diagnosis of Mandragora poisoning was made on the basis of clinical symptoms and signs of anticholinergic syndrome associated with a history of vegetable meal of uncontrolled origin, moreover analysing the vegetable obtained from gastric lavage. Decontamination and symptomatic treatment were useful in our patient to control acute poisoning.
Anticholinergic syndrome due to the adverse or toxic effects of several drugs is not an infrequent occurrence in the emergency department, and a differential diagnosis must be made. Causative agents such as drugs (tricyclic antidepressants, antihistamines, antiparkinsonism drug overdose), adverse effects from the ophthalmic use of atropine or scopolamine plasters and sympathomimetic syndrome due to cocaine, amphetamines or other drugs should be considered. Less frequently, agents, such as some types of vegetables, should be keep in mind to avoid medical mistakes. Only an accurate history and physical examination should lead to identification of the causal agent, allowing correct patient assessment and treatment.
Mandragora Autumnalis is a solanaceous plant that grows wild in the Sicilian countryside. It is an annual herb with oblong ovate leaves and blue violet flowers, which if eaten is to able to provoke an anticholinergic syndrome, and it must not be mistaken for 'mandrake' or American Mandragora.
Because of the 'human body' shape of its root and its narcotic and poisonous effects, from ancient times this plant, also known as 'Devil's herb', was believed to be an aphrodisiac and to have magic and medical properties. In 1518, Niccolò Machiavelli wrote the famous Italian tale 'Mandragola', underlining the 'medical' use of a Mandragora potion for infertility treating.
We report a case of anticholinergic syndrome due to unintentional assumption of Mandragora with clinical effects of its alkaloids.
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