DOI: 10.12890/2017_000742

Mad Honey Disease

Authors

  • Laurentiu Broscaru Department of Internal Medicine, St. Marienhospital, Oberhausen, Germany
  • Claudiu Dobre Department of Internal Medicine, St. Marienhospital, Oberhausen, Germany
  • Frederik Rösick Department of Internal Medicine, St. Marienhospital, Oberhausen, Germany
  • Arnela Halilovic Department of Internal Medicine, St. Marienhospital, Oberhausen, Germany
  • Dietrich Gulba Department of Internal Medicine, St. Marienhospital, Oberhausen, Germany

laurentiubroscaru@yahoo.com

Abstract

A 46-years old woman presented with acute onset of nausea, vomiting and prostration in the ER. She appeared ill and was 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 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.  

View the entire article

Downloads

References

  1. Jansen, S. A., et al. (2012). "Grayanotoxin poisoning: 'mad honey disease' and beyond." Cardiovasc Toxicol 12(3): 208-215.
  2. Lennerz, C., et al. (2012). "Sinus arrest from mad honey disease." Ann Intern Med 157(10): 755-756.
  3. Choo, Y. K., et al. (2008). "Cardiac problems in mad-honey intoxication." Circ J 72(7): 1210-1211.
  4. Dur, A., et al. (2014). "Mad honey intoxication mimicking acute coronary syndrome." J Pak Med Assoc 64(9): 1078-1080.
  5. Adrienne Mayor, Mad Honey! [Toxic honey]" Archaeology (November-December 1995): 32-40.
  6. Gunduz A, Kalkan A, Turedi S, Durmus I, Turkmen S, Ayaz FA, Ayar A. ”Pseudocholinesterase Levels Are Not Decreased in Grayanotoxin (Mad Honey) Poisoning in Most Patients”

Published

2017-11-20

Issue

Vol. 5 No. 1 (2018)

How to Cite

1.
Broscaru L, Dobre C, Rösick F, Halilovic A, Gulba D. Mad Honey Disease. EJCRIM [Internet]. 2017 Nov. 20 [cited 2026 Nov. 3];5(1). Available from: https://ejcrim.com/index.php/ejcrim/article/view/742