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Acute demyelinating encephalitis due to Abrus precatorius poisoning--complete recovery after steroid therapy

Ratnakar Sahoo1, Abdoul Hamide, S Deepak Amalnath

  • 1Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India. drksahoo@gmail.com

Clinical Toxicology (Philadelphia, Pa.)
|September 3, 2008
PubMed
Abstract

Insights

Abrus precatorius poisoning, caused by abrin, can rarely lead to immune-mediated demyelination. This case highlights successful treatment of abrin-induced demyelination with corticosteroids, showing potential therapeutic benefits.

Area of Science:

  • Toxicology
  • Neurology
  • Immunology

Background:

  • Abrus precatorius contains abrin, a toxalbumin inhibiting protein synthesis.
  • Abrin poisoning can rarely trigger immuno-mediated demyelination.
  • This report details a unique case of abrin poisoning with neurological complications.

Observation:

  • A 19-year-old male ingested crushed Abrus precatorius seeds.
  • Symptoms included gastrointestinal distress, seizures, and altered consciousness.
  • Brain MRI revealed demyelination in the medial temporal lobes.

Findings:

  • Abrin acts as an immunomodulator, potentially causing demyelination.
  • Corticosteroid therapy (methylprednisolone and prednisone) was administered.
  • The patient experienced a full clinical recovery.

Implications:

  • Demyelination is a rare but serious complication of Abrus precatorius poisoning.
  • Corticosteroids may be a viable treatment for abrin-induced demyelination.
  • Further clinical validation is needed to confirm the efficacy of corticosteroid therapy.

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