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

Am J Emerg Med. 2020 Jun;38(6):1296.e1-1296.e3. doi: 10.1016/j.ajem.2020.01.019. Epub 2020 Jan 9.

Abstract

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.

Keywords: Lipid peroxidation; N-acetylcysteine; Reactive oxygen species; Rotenone; Yam bean seed poisoning.

Publication types

  • Case Reports

MeSH terms

  • Acidosis, Lactic / complications
  • Acidosis, Lactic / etiology
  • Coma / etiology
  • Female
  • Humans
  • Middle Aged
  • Oxidative Stress / drug effects
  • Pachyrhizus / adverse effects*
  • Rotenone / adverse effects
  • Rotenone / analysis*
  • Rotenone / blood
  • Seizures / etiology

Substances

  • Rotenone