The syndrome of inappropriate antidiuretic hormone secretion after giant leaf frog (Phyllomedusa bicolor) venom exposure.
Toxicon : official journal of the International Society on Toxinology September 15, 2016 Vid Leban, Gordana Kozelj, Miran Brvar
A 44-year-old woman in Slovenia developed severe hyponatremia (116 mmol/L) and plasma hypoosmolality (251 mOsm/kg) after participating in a Kambô ritual that involved applying dried skin secretion from the giant leaf frog (Phyllomedusa bicolor) to five fresh burns on her shoulder, followed by drinking 6 liters of water. Laboratory findings showed inappropriately elevated urine osmolality (523 mOsm/kg) and high urine sodium (87 mmol/L), indicating syndrome of inappropriate antidiuretic hormone secretion (SIADH). She experienced nausea, vomiting, confusion, lethargy, muscle weakness, spasms, cramps, seizure, decreased consciousness, and short-term memory loss. Treatment with 0.9% sodium chloride and water restriction improved plasma osmolality and sodium within one day, but symptoms resolved only after three days.