Treatment of Toad Venom Poisoning With Digoxin-Specific Fab Fragments

  • R. Brubacher Jeffrey
    Reprint requests: Dr. Jeffrey Brubacher, Dept of Emergency Medicine, Vancouver Hospital and Health Sciences Centre, 855 West 12th Avenue, Vancouver, BC, Canada V5Z 1M9
    From the New York City Poison Control Center, New York City Department of Health

    Currently at the Vancouver Hospital and Health Sciences Centre, Vancouver, BC, Canada
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  • R. Ravikumar Padinjarekuttu
    From the New York City Poison Control Center, New York City Department of Health

    the Bureau of Laboratories, New York City Department of Health
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  • Bania Theodore
    From the New York City Poison Control Center, New York City Department of Health

    Currently at the Department of Emergency Medicine, Columbia Hospital Center, New York
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  • B. Heller Michael
    From the New York City Poison Control Center, New York City Department of Health

    the Bureau of Laboratories, New York City Department of Health

    the Environmental Sciences Division, New York City Department of Health
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  • S. Hoffman Robert
    From the New York City Poison Control Center, New York City Department of Health

    the Department of Emergency Medicine, Bellevue Hospital Center, New York
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      Toxicity from toad venom poisoning is similar to digoxin toxicity and carries a high mortality rate. We report on six previously healthy men who developed vomiting and bradycardia after ingesting a purported topical aphrodisiac. Each patient had positive apparent digoxin levels and the first four patients died of cardiac dysrhythmias. The last two patients recovered following treatment with digoxin Fab fragments. We analyzed samples of the purported aphrodisiac and found that it was identical to Chan Su, a Chinese medication made from toad venom. To our knowledge, this is the first reported use of digoxin Fab fragments to treat toad venom poisoning.

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