Grayanotoxin levels in blood, urine and honey and their association with clinical status in patients with mad honey intoxication
Ali Aygun1, Aynur Sahin2, Yunus Karaca2, Suha Turkmen3, Suleyman Turedi2, Su Youn Ahn4, Suncheun Kim4, Abdulkadir Gunduz2
1Department of Emergency Medicine, Ordu University Education and Research Hospital, Ordu, Turkey
2Department of Emergency Medicine, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
3Department of Emergency Medicine, Acıbadem University, Faculty of Medicine, Istanbul, Turkey
4Department of Forensic Toxicology, National Forensic Service, Daejeon Institute, Daejeon, Republic of Korea
Keywords: Mad honey, Grayanotoxin, LC-MS/MS, Blood, Urine, Pulse, Blood pressure
Objectives: The purpose of this study was to investigate whether there is an association between grayanotoxin levels in urine and blood of patients with mad honey intoxication and in the honey consumed, and the resulting clinical picture. The pilot data acquired from this study was analysed in National Forensic Service, Daejeon Institute, South Korea and first results were published as a preliminary study.
Patients and methods: This descriptive study was conducted at a university hospital emergency department in Turkey. 25 cases diagnosed with mad honey intoxication were obtained the study. Samples of mad honey consumed by patients were obtained. Blood and urine specimens were collected at presentation to the emergency department. GTX 1 and GTX 3 levels from patients' blood, urine and honey consumed were investigated simultaneously using the LC-MS/MS system.
Results: Mean GTX 1 concentration in blood was 4.82 ng/mL and mean GTX 3 level 6.56 ng/mL. Mean GTX concentration in urine was 0.036 μg/mL and mean GTX 3 level 0.391 μg/mL. Mean GTX I concentration in honeys consumed was 8.73 μg/gr and mean GTX 3 level 27.60 μg/gr.
Conclusion: This descriptive study is show grayanotoxin levels in body fluids of patients with mad honey intoxication. No association was determined between grayanotoxin levels in blood and clinical data.