Holiday Tox: In the beloved Dr. Seuss story “How the Grinch Stole Christmas”, the song unforgettably sung by Thurl Ravenscroft compares him to sandwich with two toxic substances.
1. If one were to eat the Grinch sandwich, what effects might follow?
2. What antidotes may be helpful?
3. What are the two toxic substances?
1. a. Delayed nausea/vomiting/diarrhea, liver failure, kidney injury, and possibly death.
1. b. Nausea/vomiting/diarrhea, muscle cramps, paresthesias, electrolyte derangements, and possibly death.
2.a. Silibinin (possibly N-acetylcysteine or others).
2 b. Chelator such as succimer (DMSA) or dimercaprol (BAL).
3 a. Amanita mushrooms
The final line of the song is: “You’re a three decker sauerkraut and toadstool sandwich with arsenic sauce!”
Hantson P, Haufroid V, Buchet JP, Mahieu P. Acute arsenic poisoning treated by intravenous dimercaptosuccinic Acid (DMSA) and combined extrarenal epuration techniques. J Toxicol: Clin Toxicol 2003, 41:1, 1-6, DOI: 10.1081/CLT-120018263
French LK, Hendrickson RG, Horowitz BZ. Amanita phalloides poisoning. Clin Toxicol 2011, 49:2, 128-129, DOI: 10.3109/15563650.2011.557663
Contributed by: Michael Mullins, MD