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Acute selenium poisoning by paradise nuts (Lecythis ollaria)
1GIZ-Nord Poisons Centre, Universitätsmedizin Göttingen, Georg-August-Universität, Göttingen, Germany. dmueller@med.uni-goettingen.de
Human & Experimental Toxicology
|January 29, 2010
Summary
Two women experienced severe symptoms like hair loss and nail discoloration after consuming paradise nuts. Delayed blood tests revealed toxic selenium levels, confirming the cause of their illness.
Area of Science:
- Toxicology
- Nutritional Science
- Clinical Medicine
Background:
- Unexplained severe symptoms including nausea, vomiting, headache, dizziness, hair loss, and nail discoloration occurred in two previously healthy women.
- Initial diagnostic evaluations and standard toxicological screenings (thallium, arsenic) were inconclusive.
- Symptoms persisted despite therapeutic interventions.
Purpose of the Study:
- To identify the cause of severe, unexplained toxicological symptoms in two patients.
- To investigate potential environmental or dietary exposures linked to the patients' health decline.
- To establish a definitive diagnosis and etiological link for the observed clinical presentation.
Main Methods:
- Clinical observation and detailed symptom documentation.
- Comprehensive diagnostic workup, including blood tests for common toxins.
- Delayed quantitative determination of serum selenium levels weeks after symptom onset.
- Retrospective analysis of dietary intake, specifically focusing on potential exposure to exotic foods.
Main Results:
- Standard toxicological tests for thallium and arsenic yielded normal results.
- Delayed quantitative analysis revealed significantly elevated serum selenium levels in both patients (Case I: 479 microg/L; Case II: 300 microg/L).
- A retrospective dietary history identified the ingestion of paradise nuts as a potential source of selenium toxicity.
Conclusions:
- Ingestion of paradise nuts can lead to severe selenium toxicity.
- Delayed diagnostic testing for specific elements like selenium is crucial when initial evaluations are unrevealing.
- This case highlights the importance of thorough dietary history in diagnosing environmental and food-borne toxicities.
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