Mad-honey poisoning results from the ingestion of grayanotoxin-contaminated honey, which is extracted by bees from the leaves and the flowers Rhododendron species. The grayanotoxins bind to sodium channels in cell membranes and prevent inactivation; thus, excitable cells are maintained in a state of depolarization. Cardiac disturbances are the main signs in this poisoning. Bradycardia, and arterial hypotension have the potential to cause death in untreated cases but no fatalities have been reported in the literature. Here, we report three cases of mad-honey poisoning. All of the patients showed bradycardia, hypotension, and syncope. The hypotension responded to the administration of fluids, and the bradycardia responded to atropine treatment. All three patients recovered fully within 24 hours. Mad-honey poisoning should be kept in mind for any patients admitted with unexplained hypotension, bradycardia, and other rhythm disturbances, and patients who have eaten honey must be examined carefully.
Atropine ; Bees ; Bradycardia ; Cell Membrane ; Eating ; Emergencies* ; Flowers ; Honey ; Humans ; Hypotension ; Poisoning* ; Rhododendron ; Sodium Channels ; Syncope

Intoxifications caused by toxic honey were occurred recently in Korea. Honey poisoning is known to be induced by grayanotoxins, that appear in flowers of different species of Rhododendron. These toxic compounds cause depolarization of membranes that contain fast Na channel by increasing in Na permeability. After ingestion of toxic honey patients may present with neurological, cardiovascular, gastrointestinal sign and symptoms. Two cases of honey poisoning are described here. Both patients experienced syncope and severe arterial hypotension after ingestion of honey which was brought from Nepal and Brazil. Conservative treatement was fully successful in both patients within 24 hours. We report the first case of honey poisoning in Korea.
Brazil ; Eating ; Flowers ; Honey* ; Humans ; Hypotension ; Korea ; Membranes ; Nepal ; Permeability ; Poisoning* ; Rhododendron ; Sick Sinus Syndrome ; Syncope*

PURPOSE: The aim of this study was to evaluate the clinical characteristics and outcome of patients who presented to the emergency department (ED) with cardiotoxicity caused by ingestion of Himalayan mad honey. METHODS: Medical records of 12 patients who presented to the ED from January 1, 2005 to December 31, 2012 with cardiotoxicity caused by ingestion of Himalayan mad honey were retrospectively reviewed. RESULTS: The mean age of patients was 54.5 years and 58.3% were men. The median amount of mad honey ingested was 30.0 cc, and the mean time from ingestion to onset of symptoms was 39.4 minutes. All patients had hypotension and bradycardia upon arrival in the ED. The initial electrocardiogram showed sinus bradycardia in seven patients, junctional bradycardia in four patients, and atrial fibrillation with slow ventricular response in one patient. Four patients were treated with intravenous normal saline solution only. Eight patients were treated with intravenous normal saline solution and atropine sulfate in a dose ranging from 0.5 to 2.0 mg. Blood pressure and pulse rate returned to normal limits within 24 hours in all patients. CONCLUSION: Our study showed that all patients with cardiotoxicity caused by ingestion of Himalayan mad honey had severe hypotension, bradycardia, and bradyarrythmias, including sinus bradycardia and junctional bradycardia and all patients responded well to conservative treatment, including intravenous normal saline solution and intravenous atropine sulfate.
Atrial Fibrillation ; Atropine ; Blood Pressure ; Bradycardia ; Eating ; Electrocardiography ; Emergencies ; Heart Rate ; Honey* ; Humans ; Hypotension ; Male ; Medical Records ; Poisoning ; Retrospective Studies ; Sodium Chloride

No abstract available.
Coronary Angiography ; Electrocardiography ; Flowers ; Honey/*poisoning ; Humans ; Inferior Wall Myocardial Infarction/*chemically induced/diagnosis/therapy ; Male ; Middle Aged ; Plant Nectar ; Predictive Value of Tests ; *Rhododendron ; Risk Factors ; Toxins, Biological/*poisoning