Hypertensive crisis and anticholinergic toxidrome secondary to accidental consumption of datura stramonium in two children

• Published in: Annales de cardiologie et d'angeiologie Vol. 67; no. 3; p. 215
• Main Authors: Batouche, D D, Benatta, N-F, Tabeliouna, K, Boudjahfa, S, Touhami, Y, Hakkoum, S
• Format: Journal Article
• Language: English; French
• Published: France 01-06-2018
• Subjects: Anticholinergic Syndrome - diagnosis; Anticholinergic Syndrome - etiology; Child, Preschool; Datura stramonium - poisoning; Humans; Hypertension - chemically induced; Hypertension - diagnosis; Male; Plant Poisoning - diagnosis; Alkaloids; Alcaloïde; Évolution; Datura stramonium; Outcome; Atropine; Poisoning; Intoxication; Poussée tensionnelle; Hypertension crisis
• ISSN: 1768-3181
• DOI: 10.1016/j.ancard.2018.04.017

To identify a hypertensive clinical form of atropine or anticholinergic toxidrome secondary to accidental consumption of Datura seeds.
We report two cases of Datura intoxication in two children who presented marked anticholinergic syndrome whose diagnosis was made by the anamnesis and the clinic.
Patient 1: A 5-year-old boy, returns home agitated with balance disorders. He was admitted to pediatric resuscitation unit. His Glasgow score was 11/15. The child made inconsistent remarks. The neurological examination revealed mydriasis. Hemodynamically, the blood pressure was 145/91mmHg, the heart rate was 145 bpm. The rest of the examination noted a temperature of 37.5°, a bladder globe. Standard biological tests were normal. ECG found sinus tachycardia. Urine analysis revealed a positive alkaloid reaction with the presence of atropine. The evolution was favorable after 48hours. Patient 2: 45-month-old boy admitted to a state of severe agitation of toxic origin. The clinical examination showed a central and peripheral anticholinergic symptomatology with severe hallucinations, severe hypertension, and a heart rate at 190 bpm. The rest of the examination found erythema in the thorax and upper limbs, bilateral mydriasis. The toxicological report confirmed the presence of alkaloids. The evolution was favorable.
Hypertension crisis and other anticholinergic clinical signs of Datura stramonium intoxication achieve favorable outcomes in children.