URGINEA MARITIMA (SQUILL) TOXICITY

A 55 year-old female ingested Mo bulbs of Urginea maritime (squill) pl ant as a folk remedy for her arthritic pains. Her past history was sig nificant for Hashimoto thyroiditis and she was hypothyroid upon presen tation. Subsequent effects resembling those seen with cardiac glycosid e intoxication included nausea, vomiting, seizures, hyperkalemia, atri oventricular block and ventricular arrhythmias resembling digitalis to xicity. A serum digoxin level by an enzyme immunoassay method was 1.59 ng/mL. Despite supportive treatment and pacing, the patient expired f rom ventricular arrhythmias 30 h after ingestion. Squill has been reco gnized since antiquity for the clinical toxicity of its cardiac glycos ides, but this appears to be the first report of a fatality since 1966 .