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

2005 ◽  
Vol 94 (12) ◽  
pp. 817-823 ◽  
Author(s):  
C. Camphausen ◽  
N. A. Haas ◽  
A. C. Mattke
Keyword(s):  
Successful Treatment ◽  
Cardiac Glycosides ◽  
Antibody Fragments

scholarly journals Severe symptomatic bradycardia after a dinner of spicy oleander soup

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Andrea Tampieri ◽  
Fabrizio Mucci ◽  
Valeria Palmonari ◽  
Eugenio Giovannini ◽  
Tiziano Lenzi ◽  
...  
Keyword(s):  
Cardiac Glycosides ◽  
Normal Sinus Rhythm ◽  
Antibody Fragments ◽  
Nerium Oleander ◽  
Normal Sinus ◽  
Dyspeptic Symptoms ◽  
History Of ◽  
Ecg Alterations ◽  
Symptomatic Bradycardia ◽  
Ornamental Shrub

Introduction: Cardiac glycosides similar to digoxin are produced by different plants in nature. Nerium oleander, commonly grown as an ornamental shrub, can be found worldwide in temperate countries. Intentional or accidental ingestion of any part of the plant can lead to clinically relevant intoxication. Case report: A 63 year old woman came to the emergency department with acute dyspeptic symptoms after eating vegetable soup flavored with unfamiliar flowers she have collected herself. However, the ECG showed abnormalities that raised suspicions for an overdose of digoxin-like cardiac glycosides. The patient was not on treatment with digoxin and a careful anamnesis revealed that she had eaten oleander leaves. Digoxin specific Fab antibody fragments were administered for marked bradycardia that was not responding to atropine administration, after counseling with the reference toxicology center. The patient was also treated with activated charcoal and magnesium sulphate, intravenous fluids and pantoprazole. Four days later she was discharged as asymptomatic, with normal sinus rhythm. Conclusion: Emergency physicians should be aware of this type of poisoning, especially in cases with typical ECG alterations in patients not treated with digoxin and medical history of plants ingestion. Cardio-active glycosides are present in different plants, often used inappropriately, with potential toxic effects and harmful drug interactions.

scholarly journals Updates in Digoxin Toxicity and Outcome of Management: A Review

2021 ◽  
pp. 403-409
Author(s):  
Imad Ahmad Ibrahim ◽  
Raghad Abdullah Alotaibi ◽  
Abdalah Emad Almhmd ◽  
Rahaf Ibrahim Alghamdi ◽  
Adnan Tawfiq Almogbel ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Cardiac Glycosides ◽  
Clinical Symptoms ◽  
Early Recognition ◽  
Digoxin Concentration ◽  
Antibody Fragments ◽  
Specific Diagnosis ◽  
Heart Failure Patients ◽  
Life Threatening

Cardiac glycosides, including digitalis and digoxin, have long-standing use in clinical practice. Digoxin has a half-life that varies from 36 to 48 hours, which may increase in cases of renal failure. Approximately 1% of Congestive Heart Failure patients treated with digoxin develop toxicity. The clinical features of toxicity are often non-specific. Diagnosis is difficult and usually made clinically, as levels of digoxin in the blood do not necessarily correlate with toxicity. Treatment involves early recognition and the administration of antibodies specifically against digoxin also known as Fab fragments. Digoxin concentration does not necessarily correlate with clinical symptoms of toxicity however digoxin concentrations may be used for calculating the amount of antidote therapy. Digoxin-specific antibody fragments are used when there is a risk of a life-threatening arrhythmia.

Specific Labeling of Protein Domains with Antibody Fragments

1981 ◽  
Vol 39 ◽  
pp. 416-417
Author(s):  
U. Aebi ◽  
L.E. Buhle ◽  
W.E. Fowler
Keyword(s):  
Image Processing ◽  
Specific Protein ◽  
Antibody Fragments ◽  
Supramolecular Organization ◽  
Two Dimensional ◽  
Ordered Structures ◽  
Virus Capsids ◽  
Processing Techniques

Many important supramolecular structures such as filaments, microtubules, virus capsids and certain membrane proteins and bacterial cell walls exist as ordered polymers or two-dimensional crystalline arrays in vivo. In several instances it has been possible to induce soluble proteins to form ordered polymers or two-dimensional crystalline arrays in vitro. In both cases a combination of electron microscopy of negatively stained specimens with analog or digital image processing techniques has proven extremely useful for elucidating the molecular and supramolecular organization of the constituent proteins. However from the reconstructed stain exclusion patterns it is often difficult to identify distinct stain excluding regions with specific protein subunits. To this end it has been demonstrated that in some cases this ambiguity can be resolved by a combination of stoichiometric labeling of the ordered structures with subunit-specific antibody fragments (e.g. Fab) and image processing of the electron micrographs recorded from labeled and unlabeled structures.

Successful treatment with topical PUVA of nodular cutaneous plasmacytosis associated with alopecia of the scalp

1996 ◽  
Vol 21 (5) ◽  
pp. 360-364 ◽  
Author(s):  
M. KANEDA ◽  
K. KURODA ◽  
M. FUJITA ◽  
H. SHINKAI
Keyword(s):  
Successful Treatment
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