Myocarditis from the Chinese Sumac Tree
Authors: John D. Bisognano, Kevin S. McGrody, Abraham M. Spence
Journal: Annals of Internal Medicine (2005)

Letters19 July 2005Myocarditis from the Chinese Sumac TreeJohn D. Bisognano, MD, PhD, Kevin S. McGrody, MD, and Abraham M. Spence, BAJohn D. Bisognano, MD, PhDFrom University of Rochester Medical Center, Strong Memorial Hospital, Rochester, NY 14642., Kevin S. McGrody, MDFrom University of Rochester Medical Center, Strong Memorial Hospital, Rochester, NY 14642., and Abraham M. Spence, BAFrom University of Rochester Medical Center, Strong Memorial Hospital, Rochester, NY 14642.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-2-200507190-00031 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Myocarditis is commonly assumed to be infectious in origin in many patients who present to the emergency department with chest pain, depressed ejection fraction, and a history compatible with a viral syndrome. Certain naturally occurring products, such as quassinoids in tree sap, may also cause myocarditis.Objective: To describe a case of myocarditis likely due to exposure to sap from the Chinese sumac tree (Ailanthus altissima).Case Report: A previously robust, healthy 24-year-old man presented to the emergency department reporting 3 days of fever and chills associated with epigastric pain, substernal chest pressure that radiated to ...References1. Joshi BC, Pandey A, Sharma RP, Khare A. Quassinoids from Ailanthus excelsa. Phytochemistry. 2003;62:579-84. [PMID: 12560029] CrossrefMedlineGoogle Scholar2. Okunade AL, Bikoff RE, Casper SJ, Oksman A, Goldberg DE, Lewis WH. Antiplasmodial activity of extracts and quassinoids isolated from seedlings of Ailanthus altissima (Simaroubaceae). Phytother Res. 2003;17:675-7. [PMID: 12820239] CrossrefMedlineGoogle Scholar3. Tamura S, Fukamiya N, Okano M, Koyama J, Koike K, Tokuda H, et al. Three new quassinoids, ailantinol E, F, and G, from Ailanthus altissima. Chem Pharm Bull (Tokyo). 2003;51:385-9. [PMID: 12672989] CrossrefMedlineGoogle Scholar4. Chang YS, Woo ER. Korean medicinal plants inhibiting to human immunodeficiency virus type 1 (HIV-1) fusion. Phytother Res. 2003;17:426-9. [PMID: 12722157] CrossrefMedlineGoogle Scholar5. Rosati A, Quaranta E, Ammirante M, Turco MC, Leone A, De Feo V. Quassinoids can induce mitochondrial membrane depolarisation and caspase 3 activation in human cells [Letter]. Cell Death Differ. 2004;11 Suppl 2 S216-8. [PMID: 15608695] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Rochester Medical Center, Strong Memorial Hospital, Rochester, NY 14642.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySectoral Impacts of Invasive Species in the United States and Approaches to ManagementImpact of Non-native Animals and Plants on Human HealthReview on Invasive Tree of Heaven (Ailanthus altissima (Mill.) Swingle) Conflicting Values: Assessment of Its Ecosystem Services and Potential Biological ThreatBiocontrol of Ailanthus altissima : inoculation protocol and risk assessment for Verticillium nonalfalfae (Plectosphaerellaceae: Phyllachorales)Surgery for a tree surgeon? Acute presentation of contact dermatitis due to Ailanthus altissimaFamilies with Species of Questionable Toxicity or SignificanceInvasive Species Defined in a Policy Context: Recommendations from the Federal Invasive Species Advisory CommitteeOn the CoverBiological flora of Central Europe: Ailanthus altissima (Mill.) SwingleTop 20 environmental weeds for classical biological control in Europe: a review of opportunities, regulations and other barriers to adoption 19 July 2005Volume 143, Issue 2Page: 159-160KeywordsEjection fractionEmergency departmentHIV infectionsHeart rateIschemiaLaboratory testsMyocarditisThoraxToxinsTroponin T ePublished: 19 July 2005 Issue Published: 19 July 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...