Mad Honey Disease

Mad Honey Disease

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A 46-years old woman presented with acute onset of nausea, vomiting and prostration in the ER.She appeared ill and was Bosch KIR81AFE0G Serie 6 A++ E Built In Larder Fridge 319 Litres White poorly responsive to verbal stimuli.The physical examination showed a systolic blood pressure of 60 mmHg and a pulse of 40 bpm.ECG was notable for slight ST-elevations in the inferior leads.Right ventricular myocardial infarction with cardiogenic shock and bradycardia was suspected.

Supportive therapy with catecholamines was initiated and a emergency coronary angiography was arranged.However, lab results showed normal troponin levels and a subsequent echocardiogram showed the absence of abnormal wall motions.By thorough history taking with the spouse it turned out that the patient had consumed a Turkish honey approximately an hour before the beginning of the symptoms.The patient made a full recovery within 24 hours with only supportive therapy.In retrospect the clinical presentation was highly indicative of poisoning with Grayanotoxins from a plant, Rhododendron, which is found as contaminant in some sorts of honey in the Black Sea area.

A pollen Files analysis confirmed the presence of Rhododendron in a honey sample.Historically this poisoning is mentioned over the millennia as mad honey disease.The ST-elevations in the ECG were a sign of early repolarization, a non-pathological finding.