Tags

Type your tag names separated by a space and hit enter

Castor bean seed ingestions: a state-wide poison control system's experience.
Clin Toxicol (Phila). 2014 Apr; 52(4):265-8.CT

Abstract

CONTEXT

Ingestions of the seed of the castor bean plant (Ricinus communis) carries the risk of toxicity from ricin, a potent inhibitor of protein synthesis.

OBJECTIVE

We sought to describe characteristics of castor bean seed exposures reported to a state-wide poison control system.

METHODS

This was an observational case series. A state-wide poison control system's database was reviewed for exposures to castor bean plant seeds from 2001 to 2011. Case notes were reviewed and data collected, when available, included age, gender, circumstances surrounding exposure, number of castor beans consumed, whether beans were chewed or crushed, symptoms described, laboratory values (aspartate aminotransferase [AST], alanine aminotransferase [ALT], prothrombin time [PT] and international normalized ratio [INR]), duration of follow-up, treatment, and patient outcomes.

RESULTS

Eighty-four cases were identified. Ingestions were unintentional in 50 cases (59%) cases and intentional in 34 (40%) cases. A median of 10 seeds (range: 1-20) were ingested in intentional cases versus 1 seed (range: 1-40) in unintentional cases. In 49 (58%) of cases the seeds were reported to have been chewed or crushed. Gastrointestinal symptoms were the most commonly reported symptoms. Vomiting (n = 39), nausea (n = 24), diarrhea (n = 17), and abdominal pain (n = 16) predominated. One patient developed hematochezia and vomiting after reportedly ingesting and intravenously injecting castor bean seeds. Laboratory values were documented in 17 (20%) cases. Only one abnormality was noted; an asymptomatic patient one week following ingestion had AST/ALT of 93 U/L and 164 U/L, respectively. Ricinine was confirmed in the urine of two patients. Twenty-three (27%) cases received activated charcoal. Seventy-two (86%) of cases were calls from health care facilities or referred to health care facilities by the poison control center. Twenty-two (26%) cases were admitted for a median of 2 days (range: 1-10). Admitted cases ingested a median of 8.5 seeds (range: 1-20). Intentional ingestions were followed for median of 37.5 h (range: 0.5-285.5) while unintentional cases were followed for 14 h (range: 1-182). No delayed symptoms, serious outcomes, or deaths were reported.

DISCUSSION

Due to the presence of ricin, there is concern for serious outcomes after ingestions of the seeds of the castor bean plant. In this study GI symptoms were most commonly reported but serious morbidity or mortality was not present. The true risk of castor bean plant seed ingestions should continue to be re-evaluated.

CONCLUSION

In this retrospective review, gastrointestinal symptoms were the most common symptoms described after reported exposures to castor bean seeds. These exposures were not associated with serious morbidity, mortality, or delayed symptoms.

Authors+Show Affiliations

Poison Control Center, University of Kansas Hospital , Kansas city, KS , USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

24579983

Citation

Thornton, S L., et al. "Castor Bean Seed Ingestions: a State-wide Poison Control System's Experience." Clinical Toxicology (Philadelphia, Pa.), vol. 52, no. 4, 2014, pp. 265-8.
Thornton SL, Darracq M, Lo J, et al. Castor bean seed ingestions: a state-wide poison control system's experience. Clin Toxicol (Phila). 2014;52(4):265-8.
Thornton, S. L., Darracq, M., Lo, J., & Cantrell, F. L. (2014). Castor bean seed ingestions: a state-wide poison control system's experience. Clinical Toxicology (Philadelphia, Pa.), 52(4), 265-8. https://doi.org/10.3109/15563650.2014.892124
Thornton SL, et al. Castor Bean Seed Ingestions: a State-wide Poison Control System's Experience. Clin Toxicol (Phila). 2014;52(4):265-8. PubMed PMID: 24579983.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Castor bean seed ingestions: a state-wide poison control system's experience. AU - Thornton,S L, AU - Darracq,M, AU - Lo,J, AU - Cantrell,F L, Y1 - 2014/03/02/ PY - 2014/3/4/entrez PY - 2014/3/4/pubmed PY - 2014/6/18/medline SP - 265 EP - 8 JF - Clinical toxicology (Philadelphia, Pa.) JO - Clin Toxicol (Phila) VL - 52 IS - 4 N2 - CONTEXT: Ingestions of the seed of the castor bean plant (Ricinus communis) carries the risk of toxicity from ricin, a potent inhibitor of protein synthesis. OBJECTIVE: We sought to describe characteristics of castor bean seed exposures reported to a state-wide poison control system. METHODS: This was an observational case series. A state-wide poison control system's database was reviewed for exposures to castor bean plant seeds from 2001 to 2011. Case notes were reviewed and data collected, when available, included age, gender, circumstances surrounding exposure, number of castor beans consumed, whether beans were chewed or crushed, symptoms described, laboratory values (aspartate aminotransferase [AST], alanine aminotransferase [ALT], prothrombin time [PT] and international normalized ratio [INR]), duration of follow-up, treatment, and patient outcomes. RESULTS: Eighty-four cases were identified. Ingestions were unintentional in 50 cases (59%) cases and intentional in 34 (40%) cases. A median of 10 seeds (range: 1-20) were ingested in intentional cases versus 1 seed (range: 1-40) in unintentional cases. In 49 (58%) of cases the seeds were reported to have been chewed or crushed. Gastrointestinal symptoms were the most commonly reported symptoms. Vomiting (n = 39), nausea (n = 24), diarrhea (n = 17), and abdominal pain (n = 16) predominated. One patient developed hematochezia and vomiting after reportedly ingesting and intravenously injecting castor bean seeds. Laboratory values were documented in 17 (20%) cases. Only one abnormality was noted; an asymptomatic patient one week following ingestion had AST/ALT of 93 U/L and 164 U/L, respectively. Ricinine was confirmed in the urine of two patients. Twenty-three (27%) cases received activated charcoal. Seventy-two (86%) of cases were calls from health care facilities or referred to health care facilities by the poison control center. Twenty-two (26%) cases were admitted for a median of 2 days (range: 1-10). Admitted cases ingested a median of 8.5 seeds (range: 1-20). Intentional ingestions were followed for median of 37.5 h (range: 0.5-285.5) while unintentional cases were followed for 14 h (range: 1-182). No delayed symptoms, serious outcomes, or deaths were reported. DISCUSSION: Due to the presence of ricin, there is concern for serious outcomes after ingestions of the seeds of the castor bean plant. In this study GI symptoms were most commonly reported but serious morbidity or mortality was not present. The true risk of castor bean plant seed ingestions should continue to be re-evaluated. CONCLUSION: In this retrospective review, gastrointestinal symptoms were the most common symptoms described after reported exposures to castor bean seeds. These exposures were not associated with serious morbidity, mortality, or delayed symptoms. SN - 1556-9519 UR - https://wwww.unboundmedicine.com/medline/citation/24579983/Castor_bean_seed_ingestions:_a_state_wide_poison_control_system's_experience_ L2 - https://www.tandfonline.com/doi/full/10.3109/15563650.2014.892124 DB - PRIME DP - Unbound Medicine ER -