Human Melia azedarach poisoning

Area of Science:

• Toxicology
• Ethnobotany
• Clinical Medicine

Background:

• Melia azedarach (Ku-lian) is traditionally used in Chinese medicine for antiparasitic and antifungal purposes.
• While its toxicity is documented in veterinary medicine, human poisoning cases are infrequently reported.
• This study highlights five cases of human Melia azedarach poisoning.

Purpose of the Study:

• To report on human poisoning cases from Melia azedarach (Ku-lian) ingestion.
• To describe the clinical manifestations and outcomes of human Melia azedarach poisoning.
• To emphasize the importance of supportive care in managing Melia azedarach toxicity.

Main Methods:

• Retrospective review of cases from the Taiwan National Poison Center database.
• Inclusion of both on-site patients and telephone consultations.
• Analysis of clinical symptoms, treatment, and patient outcomes.

Main Results:

• Neurological symptoms, including weakness, myalgia, numbness, and ptosis, were the predominant manifestations in four out of five patients.
• The onset of symptoms varied significantly, from a few hours to three weeks post-ingestion.
• All five patients recovered fully without any long-term sequelae following symptomatic and supportive treatment.

Conclusions:

• Melia azedarach poisoning can present with diverse effects, including gastrointestinal, cardiovascular, respiratory, and neurological symptoms, with potential for fatality in severe instances.
• The specific limonoids responsible for human toxicity remain unidentified.
• Prompt recognition and supportive management are crucial for favorable outcomes in human Melia azedarach poisoning cases.