Skip to main content
Log in

Cardiac Effects of Mad Honey Poisoning and Its Management in Emergency Department: A Review from Turkey

  • Published:
Cardiovascular Toxicology Aims and scope Submit manuscript

Abstract

Mad honey poisoning occurs when honey containing grayanotoxin is digested. The most common clinical signs and symptoms of poisoning involve findings of digestive system irritation, severe bradycardia and hypotension and central nervous system reaction. In this review, we aimed to underline the cardiac effects of mad honey poisoning. We also aimed to raise the awareness of physicians about early diagnosis and treatment of this rare entity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price includes VAT (Canada)

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Oguzturk, H., Ciftci, O., Turtay, M. G., & Yumrutepe, S. (2012). Complete atrioventricular block caused by mad honey intoxication. European Review for Medical and Pharmacological Sciences, 16, 1748–1750.

    PubMed  CAS  Google Scholar 

  2. Uzun, H., Narci, H., Tayfur, I., Karabulut, K. U., & Karcioglu, O. (2013). Mad honey intoxication: What is wrong with the blood glucose? A study on 46 patients. European Review for Medical and Pharmacological Sciences, 17, 2728–2731.

    PubMed  CAS  Google Scholar 

  3. Saritas, A., Kandis, H., Baltaci, D., & Erdem, I. (2011). Paroxysmal atrial fibrillation and intermittent left bundle branch block: An unusual electrocardiographic presentation of mad honey poisoning. Clinics (Sao Paulo), 66, 1651–1653.

    Article  Google Scholar 

  4. Koca, I., & Koca, A. F. (2007). Poisoning by mad honey: A brief review. Food and Chemical Toxicology, 45, 1315–1318.

    Article  PubMed  CAS  Google Scholar 

  5. Jordan, J. (2006). Research highlights from the literature. Clinical Autonomic Research, 16, 198–201.

    Article  PubMed  Google Scholar 

  6. Kan, T., Hosokawa, S., Nara, S., et al. (1994). Total synthesis of (-)-grayanotoxin III. Journal of Organic Chemistry, 59, 5532–5534.

    Article  CAS  Google Scholar 

  7. Jansen, S. A., Kleerekooper, I., Hofman, Z. L., Kappen, I. F., Stary-Weinzinger, A., & van der Heyden, M. A. (2012). Grayanotoxin poisoning: ‘Mad honey disease’ and beyond. Cardiovascular Toxicology, 12, 208–215.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  8. Yaylaci, S., Kocayigit, I., Aydin, E., Osken, A., Genc, A. B., Cakar, M. A., & Tamer, A. (2014). Clinical and laboratory findings in mad honey poisoning: A single center experience. Nigerian Journal of Clinical Practice, 17, 589–593.

    Article  PubMed  CAS  Google Scholar 

  9. Nakao, M., & Seyama, I. (1984). Effect of a dihydrograyanotoxin II on the electrical activity of the rabbit sinoatrial node. Journal of Physiology, 357, 79–91.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  10. Cagli, K. E., Tufekcioglu, O., Sen, N., Aras, D., Topaloglu, S., Basar, N., & Pehlivan, S. (2009). Atrioventricular block induced by mad-honey intoxication: Confirmation of diagnosis by pollen analysis. Texas Heart Institute Journal, 36, 342–344.

    PubMed Central  PubMed  Google Scholar 

  11. Gunduz, A., Bostan, H., Turedi, S., Nuhoğlu, I., & Patan, T. (2007). Wild flowers and mad honey. Wilderness and Environmental Medicine, 18, 69–71.

    Article  PubMed  Google Scholar 

  12. Gunduz, A., Durmus, I., Turedi, S., Nuhoglu, I., & Ozturk, S. (2007). Mad honey poisoning-related asystole. Emergency Medicine Journal, 24, 592–593.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Oztasan, N., Altinkaynak, K., Akcay, F., Gocer, F., & Dane, S. (2005). Effects of made honey on blood glucose and lipid levels in rats with Streptozocin-induced diabetes. Turkish Journal of Veterinary and Animal Sciences, 29, 1093–1096.

    CAS  Google Scholar 

  14. Yarlioglues, M., Akpek, M., Ardic, I., Elcik, D., Sahin, O., & Kaya, M. G. (2011). Mad-honey sexual activity and acute inferior myocardial infarctions in a married couple. Texas Heart Institute Journal, 38, 577–580.

    PubMed Central  PubMed  Google Scholar 

  15. Okuyan, E., Uslu, A., & Ozan Levent, M. (2010). Cardiac effects of “mad honey”: A case series. Clinical Toxicology (Philadelphia), 48, 528–532.

    Article  CAS  Google Scholar 

  16. Bostan, M., Bostan, H., Kaya, A. O., Bilir, O., Satiroglu, O., Kazdal, H., et al. (2010). Clinical events in mad honey poisoning: A single centre experience. Bulletin of Environment Contamination and Toxicology, 84, 19–22.

    Article  CAS  Google Scholar 

  17. Gunduz, A., Meriçé, E. S., Baydin, A., Topbaş, M., Uzun, H., Türedi, S., & Kalkan, A. (2009). Does mad honey poisoning require hospital admission? American Journal of Emergency Medicine, 27, 424–427.

    Article  PubMed  Google Scholar 

  18. Gunduz, A., Turedi, S., Uzun, H., & Topbas, M. (2006). Mad honey poisoning. American Journal of Emergency Medicine, 24, 595–598.

    Article  PubMed  Google Scholar 

  19. Gunduz, A., Kalkan, A., Turedi, S., Durmus, I., Turkmen, S., Ayaz, F. A., & Ayar, A. (2012). Pseudocholinesterase levels are not decreased in grayanotoxin (mad honey) poisoning in most patients. Journal of Emergency Medicine, 43, 1008–1013.

    Article  PubMed  Google Scholar 

  20. Osken, A., Yaylacı, S., Aydın, E., Kocayigit, I., Cakar, M. A., Tamer, A., & Gündüz, H. (2012). Slow ventricular response atrial fibrillation related to mad honey poisoning. Journal of Cardiovascular Disease research, 3, 245–247.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  21. Bayram, N. A., Keles, T., Durmaz, T., Dogan, S., & Bozkurt, E. (2012). A rare cause of atrial fibrillation: Mad honey intoxication. Journal of Emergency Medicine, 43, 389–391.

    Article  Google Scholar 

  22. Sumerkan, M. C., Agirbasli, M., Altundag, E., & Bulur, S. (2011). Mad-honey intoxication confirmed by pollen analysis. Clinical Toxicology (Philadelphia), 49, 872–873.

    Article  CAS  Google Scholar 

  23. Sayin, M. R., Dogan, S. M., Aydin, M., & Karabag, T. (2011). Extreme QT interval prolongation caused by mad honey consumption. Canadian Journal of Cardiology, 27(870), 17–19.

    Google Scholar 

  24. Aliyev, F., Türkoglu, C., & Celiker, C. (2009). Nodal rhythm and ventricular parasystole: An unusual electrocardiographic presentation of mad honey poisoning. Clinical Cardiology, 32, 52–54.

    Article  Google Scholar 

  25. Dubey, L., Maskey, A., & Regmi, S. (2009). Bradycardia and severe hypotension caused by wild honey poisoning. Hellenic Journal of Cardiology, 50, 426–428.

    PubMed  Google Scholar 

  26. Seyama, I., Yamaoka, K., Yakehiro, M., Yoshioka, Y., & Morihara, K. (1985). Is the site of action of grayanotoxin the sodium channel gating of squid axon? Japanese Journal of Physiology, 35, 401–410.

    Article  PubMed  CAS  Google Scholar 

  27. Eller, P., Hochegger, K., Tancevski, I., Pechlaner, C., & Patsch, J. R. (2008). Sweet heart block. Circulation, 118, 319.

    Article  PubMed  Google Scholar 

  28. Weiss, T. W., Smetana, P., Nurnberg, M., & Huber, K. (2008). The honey man–second degree heart block after honey intoxication. International Journal of Cardiology, 142, 6–7.

    Article  Google Scholar 

  29. Gunduz, A., Tatli, O., & Turedi, S. (2008). Mad honey poisoning from the past to the present. Turkish Journal of Emergency Medicine, 8, 46–49.

    Google Scholar 

  30. Sohn, C. H., Seo, D. W., Ryoo, S. M., Lee, J. H., Kim, W. Y., Lim, K. S., & Oh, B. J. (2014). Clinical characteristics and outcomes of patients with grayanotoxin poisoning after the ingestion of mad honey from Nepal. Internal and Emergency Medicine, 9, 207–211.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ali Kemal Erenler.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Erenler, A.K. Cardiac Effects of Mad Honey Poisoning and Its Management in Emergency Department: A Review from Turkey. Cardiovasc Toxicol 16, 1–4 (2016). https://doi.org/10.1007/s12012-015-9310-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12012-015-9310-6

Keywords

Navigation

-