Evidence map›Paper›PMID 38129927›Full record

ArticleJournal of medical case reports2023

Recurrent malignant ventricular arrhythmias and paresthesia-a mystery revealed as aconitine poisoning: a case report.

Ole Christian Mjølstad, Maria Radtke, Eylert Brodtkorb, Frode Edvardsen, Wenche Rødseth Brede, Trond Oskar Aamo, Dag Jacobsen, Mathis Korseberg Stokke, Arne Helland

Open access · goldAbstract readCase Reports
In one paragraph

Article in Journal of medical case reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Ole Christian MjølstadClinic of Cardiology, St. Olav-Trondheim University Hospital, Torgarden, P.O box 3250, 7006, Trondheim, Norway. ole.christian.mjolstad@stolav.no.ORCID http://orcid.org/0000-0002-7836-4838
Maria RadtkeDepartment of Nephrology, St. Olav-Trondheim University Hospital, Trondheim, Norway.
Eylert BrodtkorbDepartment of Neurology and Clinical Neurophysiology, St. Olav-Trondheim University Hospital, Trondheim, Norway.
Frode EdvardsenDepartment of Clinical Pharmacology, St. Olav-Trondheim University Hospital, Trondheim, Norway.
Wenche Rødseth BredeDepartment of Clinical Pharmacology, St. Olav-Trondheim University Hospital, Trondheim, Norway.
Trond Oskar AamoDepartment of Clinical Pharmacology, St. Olav-Trondheim University Hospital, Trondheim, Norway.
Dag JacobsenDepartment of Acute Medicine, Oslo University Hospital Ulleval, Oslo, Norway.
Mathis Korseberg StokkeInstitute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway.
Arne HellandDepartment of Clinical Pharmacology, St. Olav-Trondheim University Hospital, Trondheim, Norway.
Norwegian University of Science and Technology · NOSt Olav's University Hospital · NOOslo University Hospital · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe report a case of a clinical challenge lasting for 12 months, with severe and unresolved clinical features involving several medical disciplines. CASE PRESENTATION: A 53-year-old Caucasian male, who had been previously healthy apart from a moderate renal impairment, was hospitalized 12 times during a 1-year period for a recurrent complex of neurological, cardiovascular, and gastrointestinal symptoms and signs, without any apparent etiology. On two occasions, he suffered a cardiac arrest and was successfully resuscitated. Following the first cardiac arrest, a cardiac defibrillator was inserted. During the 12th admission to our hospital, aconitine poisoning was suspected after a comprehensive multidisciplinary evaluation and confirmed by serum and urine analyses. Later, aconitine was also detected in a hair segment, indicating exposure within the symptomatic period. After the diagnosis was made, no further episodes occurred. His cardiac defibrillator was later removed, and he returned to work. A former diagnosis of epilepsy was also abandoned. Criminal intent was suspected, and his wife was sentenced to 11 years in prison for attempted murder. To make standardized assessments of the probability for aconitine poisoning as the cause of the eleven prior admissions, an "aconitine score" was established. The score is based on neurological, cardiovascular, gastrointestinal, and other clinical features reported in the literature. We also make a case for the use of hair analysis to confirm suspected poisoning cases evaluated after the resolution of clinical features.

conclusionThis report illustrates the medical challenge raised by cases of covert poisoning. In patients presenting with symptoms and signs from several organ systems without apparent cause, poisoning should always be suspected. To solve such cases, insight into the effects of specific toxic agents is needed. We present an "aconitine score" that may be useful in cases of suspected aconitine poisoning.

Indexed as

AconitineArrhythmias, CardiacHeart ArrestParesthesiaHeartHumansMaleMiddle AgedWhite PeopleAconitineAconitineArrhythmiasCardiac arrestDiagnostic challengesEpilepsyHomicidal poisoningPoisoningSeizures

Identifiers

PMID38129927
PMCPMC10740282
OpenAlexW4390060058

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.