http://www.tandfonline.com/doi/full/10. ... 15.1071025Clinical Toxicology Volume 53, Issue 7, 2015
pages 639-777
284. Thujone: It’s not all about the absintheChristine Murphy
Department of Emergency Medicine, Carolinas Medical Center,
Charlotte NC USABackground:
Thujone is a GABAA and 5HT3 antagonist frequently associated with wormwood and absinthe, but it is also
found in plants in the genus Thuja. Thuja occidentalis, which con
tains thujone, is used as a homeopathic remedy for a variety of
ailments including skin tags. Clinically significant side effects of
thujone exposure include seizure activity. We present the case of a
toddler with seizure-like activity after ingesting Tag Away®
skintag remover containing Thuja occidentalis.
Case:
A 2 y/o male with no history of seizures or febrile illness
was found by his family unresponsive, stiff, with teeth clenched
and blue lips. He was noted to have a strong odor on him and his
grandmother noted an empty 15 mL bottle of Tag Away®
(active ingredient Thuja occidentalis 6X HPUS) in the bathroom. The family was moving and minutes prior to the event, the father had noted
a full bottle. Prior to emergency medical services (EMS) arrival,
he became lethargic with more flaccid tone. On EMS arrival, the
patient started crying and vomited once. He was prescribed azithromycin and bromophene pseudophedrine with dextromethorphan
the day prior for an upper respiratory infection. His grandmother gave him a dose of cough medication about 2 hours prior to this
event. On presentation to the emergency department, he was intermittently somnolent, irritable with a hoarse cry, had truncal ataxia
and mydriatic pupils. There were short periods where he would
seem confused. His mouth, clothing, and diaper smelled strongly
like the Tag Away®
brought by family. The patient’s clothing was
removed, and his skin was washed. His BP was 94/65 mmHg,
HR 145 beats/min, RR 24 breaths/min, and rectal temperature
97.5F. Electrolytes and liver function testing were normal except
for an initial glucose of 134 mg/dL. He was monitored overnight
and returned to baseline by the next morning. Repeat electrolytes
were normal with blood sugar of 95 mg/dL, liver function tests
unchanged, and he was discharged.
Case Discussion:
Thuja occidentalis was the active ingredient
reported on the Tag Away®
label. Other ingredients included cedar
leaf oil, melaleuca leaf oil, and ricinus comminus. Based on the
history presented by the family, we suspect the patient had a seizure from ingestion of the Tag Away®, likely related to thujone in the product. This was an isolated seizure, which resolved spontaneously and was followed by a post-ictal period. The patient never developed signs of pulmonary injury or gastrointestinal symptoms and returned to baseline within about 12 hours from the time of ingestion.
Conclusions:
Tag Away®
is sold over-the-counter and generally
considered safe. This case serves to remind toxicologists that
thujone is present in a variety of products, not just absinthe.
Keywords:
Thujone, Seizure, Pediatric
E-mail:
christine.murphy66@gmail.comP.S.: Zajmavy je ze miminko prezilo 
. Snazil jsem se najit udaje o obsahu thujonu v Thuja occidentalis, ale moc se mi to ne povedlo, vim jenom z celkoveho oleje kolem 53% je smes thujonu(50% alpha) ..kazdopadne predpokladam ze byla v tom Tag Away asi moje mesicni davka absinthu 
Jinak dalsi zajmavy clanek http://www.sciencedirect.com/science/ar ... 4115001737
