A patient presents with nausea, vomiting, bradycardia and hypotension after ingesting a foraged plant. Vital signs include a heart rate of 42 bpm and blood pressure of 83/42 mmHg. Electrocardiogram reveals sinus bradycardia. Serum potassium was normal. A digoxin level returns at 0.38 ng/mL. What foraged plant can cross-react with a digoxin assay?
Veratrum viride. Bechtel LK et al. report a case of digoxin-like toxicity with a digoxin concentration of 0.38 ng/mL after a foraging error and subsequent ingestion of veratrum viride.
Bechtel LK et al. Ingestion of false hellebore plants can cross-react with a digoxin clinical chemistry assay. Clin Tox 2010; 48:435-442. DOI: 10.3109/15563651003733666