Anticholinergic syndrome after atropine overdose in a supposedly homeopathic solution: a case report
Sabrina Schmoll1, Katrin Romanek1, Gabriel Zorn1
1Department of Internal Medicine II, Division of Clinical Toxicology and Poison Control Centre Munich, TUM School of Medicine, Technical University of Munich, Munich, Germany.
Background:
A 53-year-old male with no pre-existing conditions and no permanent medication presented to our emergency department with an anticholinergic syndrome including confusion, anxiety, ataxia and dysarthria after ingestion of a homeopathic solution containing Atropa belladonna extract supposedly in a D4 dilution.
Methods:
Atropine sulphate was quantitatively analysed in serum and the homeopathic preparation via liquid chromatography/mass spectrometry.
Results:
Analysis revealed concentrations of approximately 3 mg/mL atropine sulphate in the homeopathic solution and a serum level of 5.7 ng/mL (±1.4) in the patient's blood proving a 600-fold overdose of atropine due to a production error of the homeopathic dilution. The patient was observed and recovered without further intervention.
Conclusion:
Rare but possibly dangerous manufacturing errors should be considered when faced with symptoms occurring after ingestion of homeopathic or holistic remedies.
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