海檬果

Substance

Cerbera Odollam

Photo: https://www.123rf.com/photo_73477720_seed-of-pong-pong-tree-suicide-tree-pong-pong-othalanga-cerbera-odollam-.html

 

Common name or Trade name

Pong-Pong Seeds

海檬果.

Cerberus Tree

Sea Mango

Othalanga [1]

Suicide tree

 

Involving system

Cardiac glycosides related arrhythmia

Strong cardiotoxic effects [1] 


Presentation

Nausea, vomiting, thrombocytopenia [1]

Hyperkalemia [1, 2]

Heart block [2] ECG abnormalities [1].

Death [2]

 

Antidote and Treatment

 

Supportive therapy [1]

Atropine followed by temporary pacemaker insertion [1]

Administration of digoxin immune Fab may be considered in severe cases [1]  
Disposition

Hospitalization.

  References

[1] Menezes RG, Usman MS, Hussain SA, et al. Cerbera odollam toxicity: A review. J Forensic Leg Med. 2018;58:113–116. doi:10.1016/j.jflm.2018.05.007 

[2] Wermuth ME, Vohra R, Bowman N, Furbee RB, Rusyniak DE. Cardiac Toxicity from Intentional Ingestion of Pong-Pong Seeds (Cerbera Odollam). J Emerg Med. 2018;55(4):507–511. doi:10.1016/j.jemermed.2018.05.021


-- edited 21th Feb, 2020 Yu-Jang Su.