A case of Ginkgo seed poisoning in a healthy adult

DOI 3 Citations 19 References
  • Miyazaki Dai
    Department of Emergency Medicine and Critical Care Center, Osaka City General Hospital
  • Kubota Tetsushi
    Department of Emergency Medicine and Critical Care Center, Osaka City General Hospital
  • Rinka Hiroshi
    Department of Emergency Medicine and Critical Care Center, Osaka City General Hospital
  • Kaji Arito
    Department of Emergency Medicine and Critical Care Center, Osaka City General Hospital
  • Kobayashi Daisuke
    Department of Food and Chemical Toxicology, Faculty of Pharmaceutical Sciences Health Sciences, University of Hokkaido
  • Yoshimura Teruki
    Department of Food and Chemical Toxicology, Faculty of Pharmaceutical Sciences Health Sciences, University of Hokkaido
  • Wada Keiji
    Department of Food and Chemical Toxicology, Faculty of Pharmaceutical Sciences Health Sciences, University of Hokkaido

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  • 健常成人に発症した銀杏中毒の１例

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A previously healthy 41-year-old woman presented with nausea, vomiting, vertigo, and tremors of both upper limbs that occurred 4 hours after she consumed 60 ginkgo seeds. She had stable vital signs. Laboratory tests, including complete blood count, chemical analysis of blood samples, and blood-gas analysis, were almost normal except for slight increases in white blood cell count and lactate level. Head computed tomography findings were normal. The serum concentration of 4-O-methylpyridoxine (MPN) was elevated, (339 ng/ml). After oral administration of 400 mg (8 mg/kg body weight) of pyridoxal phosphate, her symptoms improved. After admission, her symptoms did not recur. She was discharged after 2 days of observation. Because of the malnutrition of Japanese before and after World War II, ginkgo seed poisoning happened frequently. Recently, the frequency of this poisoning has decreased. MPN is the toxic component of ginkgo seeds that causes poisoning. MPN is a competitive antagonist of vitamin B6 and exerts its effects on the central nervous system; further, MPN may induce convulsions. Our patient did not have convulsions; her symptoms improved immediately after PLP administration. It is necessary to administer PLP to ginkgo seed poisoning promptly.

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