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Carboxyatractyloside poisoning in humans
Mehmet Turgut1, Cafer Cumhur Alhan, Metin Gürgöze
1Department of Pediatrics, Faculty of Medicine, Firat University, Elazig, Turkey. drmturgut@hotmail.com
Annals of Tropical Paediatrics
|June 14, 2005
Summary
Cocklebur seed poisoning from carboxyatractyloside is a serious threat, causing multiple organ dysfunction and potentially death in humans. Early recognition and supportive care are crucial due to the lack of a specific antidote.
Area of Science:
- Toxicology
- Plant-induced toxicity
- Human poisoning cases
Background:
- Cocklebur (Xanthium strumarium) seeds contain the toxic glycoside carboxyatractyloside.
- Carboxyatractyloside is known to be highly toxic to animals.
- Human poisoning cases from carboxyatractyloside have not been previously reported.
Observation:
- Nine human cases of carboxyatractyloside poisoning are presented.
- Clinical symptoms included abdominal pain, nausea, vomiting, drowsiness, palpitations, sweating, and dyspnea.
- Severe cases progressed to convulsions, loss of consciousness, and death.
Findings:
- Laboratory results indicated severe hepatocellular damage (elevated liver enzymes), renal dysfunction (raised BUN and creatinine), and myocardial injury (raised CPK-MB).
- Fatal cases exhibited consumption coagulopathy.
- Post-mortem histopathology revealed centrilobular hepatic necrosis, renal proximal tubular necrosis, and cerebral/cerebellar microvascular hemorrhage.
Implications:
- Carboxyatractyloside poisoning leads to multiple organ dysfunction and can be fatal.
- Poor prognostic indicators include coagulation abnormalities, hyponatraemia, marked hypoglycemia, icterus, and hepatic/renal failure.
- Treatment is supportive as no specific antidote is available.