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.
Similar content being viewed by others
References
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.
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.
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.
Koca, I., & Koca, A. F. (2007). Poisoning by mad honey: A brief review. Food and Chemical Toxicology, 45, 1315–1318.
Jordan, J. (2006). Research highlights from the literature. Clinical Autonomic Research, 16, 198–201.
Kan, T., Hosokawa, S., Nara, S., et al. (1994). Total synthesis of (-)-grayanotoxin III. Journal of Organic Chemistry, 59, 5532–5534.
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.
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.
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.
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.
Gunduz, A., Bostan, H., Turedi, S., Nuhoğlu, I., & Patan, T. (2007). Wild flowers and mad honey. Wilderness and Environmental Medicine, 18, 69–71.
Gunduz, A., Durmus, I., Turedi, S., Nuhoglu, I., & Ozturk, S. (2007). Mad honey poisoning-related asystole. Emergency Medicine Journal, 24, 592–593.
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.
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.
Okuyan, E., Uslu, A., & Ozan Levent, M. (2010). Cardiac effects of “mad honey”: A case series. Clinical Toxicology (Philadelphia), 48, 528–532.
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.
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.
Gunduz, A., Turedi, S., Uzun, H., & Topbas, M. (2006). Mad honey poisoning. American Journal of Emergency Medicine, 24, 595–598.
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.
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.
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.
Sumerkan, M. C., Agirbasli, M., Altundag, E., & Bulur, S. (2011). Mad-honey intoxication confirmed by pollen analysis. Clinical Toxicology (Philadelphia), 49, 872–873.
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.
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.
Dubey, L., Maskey, A., & Regmi, S. (2009). Bradycardia and severe hypotension caused by wild honey poisoning. Hellenic Journal of Cardiology, 50, 426–428.
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.
Eller, P., Hochegger, K., Tancevski, I., Pechlaner, C., & Patsch, J. R. (2008). Sweet heart block. Circulation, 118, 319.
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.
Gunduz, A., Tatli, O., & Turedi, S. (2008). Mad honey poisoning from the past to the present. Turkish Journal of Emergency Medicine, 8, 46–49.
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.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
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
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12012-015-9310-6