Concentrations of various forms of vitamin B6 in ginkgo seed poisoning

Brain Dev. 2019 Mar;41(3):292-295. doi: 10.1016/j.braindev.2018.10.007. Epub 2018 Oct 23.

Abstract

A 2-year-old girl required medical attention for a sudden onset of repetitive tonic-clonic convulsions after ingesting 20-30 ginkgo seeds. Concentrations of the major forms of circulating vitamin B6, pyridoxal-5'-phosphate (PLP), pyridoxal (PL), and 4-pyridoxic acid, as well as the known ginkgo seed toxin 4'-O-methylpyridoxine (MPN) were measured in the serum and cerebrospinal fluid (CSF). PLP is an active form of vitamin B6 and necessary for γ-aminobutyric acid (GABA) production. High MPN concentrations were observed in both the serum and CSF. As the PLP to PL ratio was markedly decreased in serum and CSF examinations, we suspected the ratio to be important in GABA production. This case report provides novel information on the metabolism of vitamin B6 in humans as a result of ginkgo seed poisoning.

Keywords: 4-Pyridoxic acid; Ginkgo seed poisoning; Pyridoxal; Pyridoxal-5′-phosphate; Vitamin B(6).

Publication types

  • Case Reports

MeSH terms

  • Child, Preschool
  • Developmental Disabilities / etiology
  • Female
  • Foodborne Diseases* / blood
  • Foodborne Diseases* / cerebrospinal fluid
  • Foodborne Diseases* / complications
  • Foodborne Diseases* / etiology
  • Ginkgo biloba
  • Glutamic Acid / metabolism
  • Humans
  • Plant Extracts / poisoning*
  • Pyridoxic Acid / metabolism
  • Pyridoxine / analogs & derivatives
  • Pyridoxine / cerebrospinal fluid
  • Pyridoxine / metabolism
  • Seeds / poisoning*
  • Vitamin B 6
  • gamma-Aminobutyric Acid / metabolism

Substances

  • 4'-O-methylpyridoxine
  • Plant Extracts
  • Ginkgo biloba extract
  • Glutamic Acid
  • gamma-Aminobutyric Acid
  • Pyridoxic Acid
  • Vitamin B 6
  • Pyridoxine