HYPOVOLEMIC SHOCK AND MORTALITY AFTER INGESTION OF TRIPTERYGIUM-WILFORDII HOOK F - A CASE-REPORT

Tripterygium wilfordii Hook F (TWHF) is a kind of Chinese herbal medic ine used for 2000 years. It was applied externally for treatment of ar thritis and inflammatory tissue swelling in early years. Recently, thi s drug has been found to have immunosuppressive effects which could su ccessfully induce remission of some autoimmune disorders without obvio us adverse effects. Although there are side effects of gastrointestina l upset, infertility and suppression of lymphocyte proliferation, litt le information about lethal toxicities has been reported. A case is pr esented here of a previously healthy young man who developed profuse v omiting and diarrhea, leukopenia, renal failure, profound hypotension and shock after ingestion of an extract of TWHF. In addition to his hy povolemic shock, serial electrocardiograms (EGG), cardiac enzyme studi es, and echocardiography also showed some evidence of coexisting cardi ac damage. He died of intractable shock 3 days after the abuse of TWHF . Further studies of the pathogenesis of peripheral collapse and possi ble cardiac toxicity, and determination of the therapeutic range of th is drug are necessary before it is used extensively.