A Possible Effect of Concentrated Oolong Tea Causing Transient Ischemic Attack-Like Symptoms.
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Date
2013-10
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Abstract
Aims: Tea (green, oolong, and black) is the second most widely consumed beverage
worldwide, second only to water. Aside from a few reported adverse effects, tea,
particularly green tea, appears to be beneficial for human health. In the case described
herein, a male experienced several transient ischemic attack-like symptoms immediately
following the consumption of a cup of high quality oolong tea. A thorough medical
evaluation uncovered no evidence of such an attack and leads to the suggestion of a
heretofore unreported response to oolong tea.
Presentation of Case: A 72-year old male with hypertension and atrial fibrillation, who
takes valsartan/hydrochlorothiazide to control hypertension and warfarin to reduce the
risk of thrombosis and thromboembolism, presented at the emergency room of a local
hospital describing several transient ischemic attack-like symptoms immediately after
consuming a cup of oolong tea. His symptoms included presyncope, disequilibrium,
bilateral hand parathesias, mild dysphasia, and visual problems (but apparently not
presbyopia or amaurosis fugax), all of which had disappeared in approximately two
hours after drinking the tea. (Mild presyncope was previously noted by the patient when
ingesting a strong green tea.) No unusual features emerged from his physical
examination, and his blood work was unremarkable except for elevation of his partial
thromboplastin time (39 sec) and prothrombin time (22.5 sec), giving an international
reference of 2.0, all consistent with the effects of warfarin. A battery of tests by the
emergency room physician, a cardiologist, and a neurologist, e.g. electrocardiogram,
brain computerized tomography, 2-dimensional transthoracic echocardiogram, brain
magnetic resonance imaging, with and without 20 ml Gadolinium, and a magnetic
resonance angiogram, confirmed the earlier diagnosis of atrial fibrillation but disclosed
no additional malfunction in his heart. His brain showed no evidence of a prior
hemorrhage, and his carotid arteries were clear.
Methodology and Results: Analysis of the oolong tea by high performance liquid
chromatography and mass spectrometry identified the major catechins and two
methylxanthines, caffeine and theophylline, as well as other constituents, but there was
no evidence of any extraneous chemicals that could lead to the symptoms.
Conclusion: In view of the rapid onset of symptoms after the consumption of oolong tea,
bilateral as opposed to unilateral parathesis, and the absence of any evidence of a
hemorrhage or the presence of impurities in the tea, we suggest that the transient
ischemic attack-like symptoms could possibly be attributable to one or more components
of the oolong tea and was not an atypical magnetic resonance imaging-negative
transient ischemic attack.
Description
Keywords
Transient ischemic attack, oolong tea, mass spectrometry, high performance, liquid chromatography
Citation
Jr John W Layher, Poling Jon S, Ishihara Mayumi, Azadi Parastoo, Alvarez-Manilla Gerardo, Puett David. A Possible Effect of Concentrated Oolong Tea Causing Transient Ischemic Attack-Like Symptoms. British Journal of Medicine and Medical Research. 2013 Oct-Dec; 3(4): 2157-2172.