Anticholinergic toxicity from nightshade berry poisoning responsive to physostigmine

J Emerg Med. Jan-Feb 1997;15(1):65-9. doi: 10.1016/s0736-4679(96)00244-2.

Abstract

The woody nightshade, Solanum dulcamara, belongs to the genus Solanum and its primary toxin is solanine. We report a large nightshade ingestion in a 4-yr-old girl who presented to the emergency department in acute anticholinergic crisis. The child was given 0.2 mg of intravenous physostigmine (0.02 mg/kg). Within 50 min, the patient received two additional equal doses with complete resolution of symptoms. After 36 h of observation, the child was discharged. Our patient presented with symptoms more suggestive of the deadly nightshade species, Atropa belladonna, which is native to Europe; however, a detailed laboratory analysis of the suspect berries revealed no atropine or hyoscyamine. Analysis did reveal sterols consistent with solanine. This is a unique case presentation of woody nightshade, S. dulcamara, poisoning presenting with anticholinergic crisis and responding to physostigmine.

Publication types

  • Case Reports

MeSH terms

  • Child, Preschool
  • Cholinergic Antagonists / analysis
  • Cholinergic Antagonists / poisoning
  • Cholinesterase Inhibitors / therapeutic use*
  • Female
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Physostigmine / therapeutic use*
  • Plant Poisoning / drug therapy*
  • Plants, Toxic / chemistry
  • Solanaceous Alkaloids / analysis
  • Solanaceous Alkaloids / poisoning*

Substances

  • Cholinergic Antagonists
  • Cholinesterase Inhibitors
  • Solanaceous Alkaloids
  • Physostigmine