Yang H, Wang YJ, Xu BP, Peng HW, Xu Q, Yu HB. Repeated atrial arrhythmia induced by cochineal red poisoning: A case report. World J Clin Cases 2023; 11(34): 8184-8191 [PMID: 38130780 DOI: 10.12998/wjcc.v11.i34.8184]
Corresponding Author of This Article
Bao-Ping Xu, Doctor, MD, Chief Doctor, Department of Intensive Care Unit, Traditional Chinese Hospital of Lu’an affiliated to Anhui University of Traditional Chinese Medicine, No. 76 Renmin Road, Lu’an 237000, Anhui Province, China. xu131406@qq.com
Research Domain of This Article
Toxicology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hao Yang, Department of Intensive Care Unit, Anhui Zhongke Gengjiu Hospital Affiliated To Anhui Medical University, Hefei 230000, Anhui Province, China
Yu-Jiao Wang, Graduate School, Anhui University of Chinese Medicine, Hefei 230031, Anhui Province, China
Bao-Ping Xu, Huai-Wen Peng, Qing Xu, Huai-Bin Yu, Department of Intensive Care Unit, Traditional Chinese Hospital of Lu’an affiliated to Anhui University of Traditional Chinese Medicine, Lu’an 237000, Anhui Province, China
Author contributions: Wang YJ, Yang H, and Xu BP contributed to conception and design of the study; Yang H and Xu Q provided study materials or recruited patients; Xu BP contributed to collection, analysis, and interpretation of data; Xu BP, Yang H, Peng HW, Xu Q, Yu HB, and Wang YJ contributed to manuscript writing and editing; Yang H, Peng HW, and Yu HB contributed to administrative support; all authors read and approved the final manuscript.
Supported byAnhui University of Chinese Medicine, No. 2022LAY012.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bao-Ping Xu, Doctor, MD, Chief Doctor, Department of Intensive Care Unit, Traditional Chinese Hospital of Lu’an affiliated to Anhui University of Traditional Chinese Medicine, No. 76 Renmin Road, Lu’an 237000, Anhui Province, China. xu131406@qq.com
Received: September 16, 2023 Peer-review started: September 16, 2023 First decision: October 17, 2023 Revised: October 29, 2023 Accepted: November 24, 2023 Article in press: November 24, 2023 Published online: December 6, 2023 Processing time: 80 Days and 16.8 Hours
Abstract
BACKGROUND
Cochineal red is an organic compound widely used in food, cosmetics, pharmaceuticals, textiles, and other fields due to its excellent safety profile. Poisoning caused by eating foods containing cochineal red is rare, and repeated atrial arrhythmia due to cochineal red poisoning is even rarer.
CASE SUMMARY
An 88-year-old Asian female patient was admitted to hospital due to a disturbance of consciousness. Twelve hours prior to presentation, the patient consumed 12 eggs containing cochineal red over a period of 2 h. At presentation, the patient was in a coma and had a score of 6 on the Glasgow Coma Scale (E2 + VT + M4). The patient’s skin and mucous membranes were pink. Electrocardiography (ECG) revealed rapid atrial fibrillation without any signs of ischemia. We prescribed cedilan and fluid replacement for arrhythmia correction. Shortly after admission, the atrial fibrillation corrected to a normal sinus rhythm. On the day 2 of admission, the patient had a sudden atrial flutter accompanied by hemodynamic instability and rapidly declining arterial oxygen saturation between 85% and 90%. The sinus rhythm returned to normal after two electrical cardioversions. Six days after admission, the skin color of the patient returned to normal, and the ECG results were normal. The patient was transferred out of the intensive care unit and eventually discharged after 12 d in hospital. At the 2-mo follow-up visit, the patient was in good health with no recurrence of arrhythmia.
CONCLUSION
Although cochineal red is a safe, natural food additive, excessive consumption or occupational exposure can induce cardiac arrhythmias.
Core Tip: Poisoning caused by eating foods containing cochineal red is rare, and repeated atrial arrhythmia caused by cochineal red poisoning is even rarer. For the first time, we report a case of repeated atrial arrhythmia caused by cochineal red poisoning. Through this case report, clinicians and the public will gain knowledge of the risks of excessive consumption of foods containing cochineal red pigment.
