Intoxicaciones por plantas en el Centro Nacional de Toxicología durante el periodo 2011 – 2017. Asunción, Paraguay
Palabras clave:
intoxicación por plantas, envenenamiento, epidemiología
Resumen
Introducción: las intoxicaciones por plantas constituyen entre 1 al 2% de todas las intoxicaciones en los centros nacionales de toxicología.
Objetivo: describir la epidemiologia de las intoxicaciones por plantas registradas en el Centro Nacional de Toxicología, Asunción, Paraguay, desde el 2011 al 2017.
Metodología: estudio observacional descriptivo con componente analítico, retrospectivo, de corte transversal, con muestreo no probabilístico por conveniencia. Se consideró intoxicación por plantas a todo caso cuya exposición a plantas motivara la consulta y tratamiento en el Centro Nacional de Toxicología.
Resultados: se incluyeron 45 intoxicaciones por plantas. La mediana de la edad fue 6 años. Se observó una mayor frecuencia en el sexo masculino (25; 55,6%). Las intoxicaciones por Aleurites fordii, Pinus elliottii, Pimpinella anisum y Jatropha curcas fueron más frecuentes en los menores de cinco años, mientras que la Brugmansia arborea, Aleurites moluccanus y Citrus aurantium predominaron en adolescentes y adultos. La intoxicación accidental (56,7%) y la relacionada a la medicina folclórica (42,9%) fueron más frecuentes en los menores de cinco años, mientras que el abuso y la tentativa suicida predominaron en adolescentes y adultos (100%) (p <0,05). En el hogar ocurrieron las mayorías de las intoxicaciones (84,4%). La ingestión fue la vía de intoxicación más frecuente (95,6%).
Conclusión: las intoxicaciones por plantas predominan en niños de sexo masculino, siendo la causa más frecuente la intoxicación accidental y la relacionada a medicina folclórica. Las plantas más involucradas fueron Brugmansia arborea, Aleurites fordii, Aleurites moluccanus y Pinus elliottii
Citas
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2. Srivastava A, Peshin SS, Kaleekal T, Gupta SK. An epidemiological study of poisoning cases reported to the National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi. Hum Exp Toxicol [Internet]. 2005 /cited 2018 Apr 25/; 24(6):279–85. Available from: http://journals.sagepub.com/doi/10.1191/0960327105ht527oa
3. Ribeiro VP, Arruda C, Abd El-Salam M, Bastos JK. Brazilian medicinal plants with corroborated anti-inflammatory activities: a review. Pharm Biol [Internet]. 2018 /cited 2019 Mar 6/; 56(1):253–68. Available from: https://www.tandfonline.com/doi/full/10.1080/13880209.2018.1454480
4. Karunamoorthi K, Jegajeevanram K, Vijayalakshmi J, Mengistie E. Traditional medicinal plants: A source of phytotherapeutic modality in resource-constrained health care settings. J Evid Based Complementary Altern Med [Internet]. 2013 /cited 2018 Mar 15/;18(1):67–74. Available from: https://journals.sagepub.com/doi/pdf/10.1177/2156587212460241
5. Da Silva ARH, Lopes LQS, Cassanego GB, de Jesus PR, Figueredo KC, Santos RCV, et al. Acute toxicity and antimicrobial activity of leaf tincture Baccharis trimera (Less). Biomed J [Internet]. 2018 /cited 2019 Mar 18/; 41(3):194–201. Available from: https://reader.elsevier.com/reader/sd/pii/S2319417017302202?token=AEDB6C345AD059FF462E816E8780305957E632CA03F382DB781E718DAE8C970741B52CF461D876FC379CB4FA0D4E73BA
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7. Barrales Cureño HJ, Ramírez Sepúlveda MF. Una revisión sobre la producción de taxoides anticancerígenos en cultivos in vitro de callos y células de Taxus spp. Rev Colomb Biotecnol [Internet]. 2013 /cited 2018 Dic 10/; 15(2):167-177. Available from: file:///C:/Users/Acer/Downloads/41743-191019-1-PB.pdf.
8. Abruzzo A, Cerchiara T, Bigucci F, Zuccheri G, Cavallari C, Saladini B, Luppi B. Cromolyn-crosslinked chitosan nanoparticles for the treatment of allergic rhinitis. Eur J Pharm Sci [Internet]. 2019 /cited 2019 Mar 20/;131:136–45. Available from: https://www.sciencedirect.com/science/article/pii/S0928098719300685?via%3Dihub
9. Ghorani-Azam A, Sepahi S, Riahi-Zanjani B, Ghamsari AA, Mohajeri SA, Balali-Mood M. Plant toxins and acute medicinal plant poisoning in children: A systematic literature review. J Res Med Sci [Internet]. 2018 /cited 2019 Mar 20/;23(1):26. Available from: http://www.jmsjournal.net/text.asp?2018/23/1/26/228589.
10. Ekor M. The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Front Pharmacol [Internet]. 2014 /cited 2019 Mar 20/; 4:177. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3887317/
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13. Tinitana F, Rios M, Romero-Benavides JC, de la Cruz Rot M, Pardo-de-Santayana M. Medicinal plants sold at traditional markets in southern Ecuador. J Ethnobiol Ethnomed [Internet]. 2016 /cited 2019 Mar 2/; 12(1):29. Available from: file:///C:/Users/Acer/Downloads/2016MedicinalplantssoldattraditionalmarketsinsouthernEcuador.pdf.
14. Fuchs J, Rauber-Lüthy C, Kupferschmidt H, Kupper J, Kullak-Ublick GA, Ceschi A. Acute plant poisoning: Analysis of clinical features and circumstances of exposure. Clin Toxicol [Internet]. 2011 /cited 2018 Dic 20/; 49(7):671–80. Available from: http://www.tandfonline.com/doi/full/10.3109/15563650.2011.597034.
15. Plenert B, Prasa D, Hentschel H, Deters M. Plant exposures reported to the Poisons Information Centre Erfurt from 2001-2010. Planta Med [Internet]. 2012 /cited 2018 Dic 20/; 78(05):401–8. Available from: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0031-1298253
16. Krenzelok EP, Mrvos R. Friends and foes in the plant world: A profile of plant ingestions and fatalities. Clin Toxicol [Internet]. 2011 /cited 2019 Mar 20/; 49(3):142–9. Available from: http://www.tandfonline.com/doi/full/10.3109/15563650.2011.568945.
17. Diaz JH. Poisoning by herbs and plants: Rapid toxidromic classification and diagnosis. Wilderness Environ Med. 2016;27(1):136–52.
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22. Martínez Monseny A, Martínez Sánchez L, Margarit Soler A, Trenchs Sainz de la Maza V, Luaces Cubells C. Poisonous plants: An ongoing problem. An Pediatr (Barc) [Internet]. 2015 /cited 2018 Nov 22/; 82(5):347–53. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2341287915000861
23. Lin TJ, Nelson LS, Tsai JL, Hung DZ, Hu SCh, Chan HM, Deng JF. Common toxidromes of plant poisonings in Taiwan. Clin Toxicol [Internet]. 2009 /cited 2018 Nov 22/; 47(2):161–8. Available from: https://pdfs.semanticscholar.org/a429/a405d3e96c72a1f8a7a489ee2aa4c30b9e23.pdf
24. Slaughter RJ, Beasley DM, Lambie BS, Wilkins GT, Schep LJ. Poisonous plants in New Zealand: a review of those that are most commonly enquired about to the National Poisons Centre. N Z Med J [Internet]. 2012 /cited 2018 Nov 22/; 125(1367):87-118. Available from: https://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2012/vol-125-no-1367/article-slaughter.
