Oxidative storm in a patient with acute rotenone-containing plant poisoning

• Published in: The American journal of emergency medicine Vol. 38; no. 6; pp. 1296.e1 - 1296.e3
• Main Authors: Yu, Jiun-Hao, Huang, Chun-Fa, Wang, Te-Hao, Hung, Dong-Zong, Mu, Han-Wei, Pan, Chi-Syuan
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2020; Elsevier Limited
• Subjects: Acetylcysteine; Acidosis; Asphyxia; Beans; Blood pressure; Coma; Consciousness; Convulsions & seizures; Electron transport; Emergency; Emergency medical care; Heart rate; Lactic acidosis; Lipid peroxidation; Lipids; Liquid chromatography; Mass spectrometry; Mass spectroscopy; Mitochondria; N-acetylcysteine; Oxidative stress; Oxygen saturation; Peroxidation; Poisoning; Reactive oxygen species; Rotenone; Seeds; Yam bean seed poisoning; Yam bean seed poisoning; Lipid peroxidation; Reactive oxygen species; Rotenone; N-acetylcysteine
• ISSN: 0735-6757; 1532-8171; 1532-8171
• DOI: 10.1016/j.ajem.2020.01.019

A 64-year-old woman presented with coma, seizure, and lactic acidosis after ingesting 80 yam bean seeds. This rotenone-containing seeds cause cellular asphyxia via blockage of the mitochondrial electron transport. Subsequent oxidative stress results in the formation of lipid peroxidation (LPO). Rotenone analysis via liquid chromatography mass spectrometry revealed the following: 31,590 ng/mL in cooked yam bean seed and 100 ng/mL in the blood. We attempted to use N-acetylcysteine to alleviate oxidative stress and documented the continuous decline in the plasma concentration of LPO.